title: Prenatal detection of fetal growth restriction in newborns classified as small for gestational age: correlates and risk of neonatal morbidity.
abstract: We examined the rate of detecting small for gestational age (SGA; birth weight < 10%) as intrauterine growth restriction (IUGR) prenatally at four centers and determined risks of composite neonatal morbidity (CNM) and mortality among detected versus undetected (no antenatal diagnosis of IUGR). A multicenter cohort study of 11,487 nonanomalous, singleton live births with sonographic exam before 22 weeks was performed. Of 11,487 births, 8% (n = 929) were SGA that met the inclusion criteria, with 25% of them being prenatally detected. The CNM among SGA births that were prenatally detected as IUGR was higher (23.3%) than undetected SGA (9.7%), but this difference was no longer significant following adjustments for confounding factors. Among preterm births (< 37 weeks), undetected SGA had significantly higher CNM (risk ratio [RR] 10.0, 95% confidence interval [CI] 6.3, 16.1) for deliveries at 24 to 33 weeks and RR 3.0, 95% CI 1.7, 5.4 for 34 to 36 weeks). In summary, only a quarter of SGA births were detected prenatally as IUGR and among preterm SGA, the CNM is significantly higher when SGA births are undetected as IUGR.
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.affiliation: Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Hind
authors.initials: H
authors.lastname: Beydoun
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Eugene
authors.initials: E
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas, Little Rock, Arkansas.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Sandlin
authors.affiliation: Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island.
authors.forename: Josh D
authors.initials: JD
authors.lastname: Dahlke
authors.affiliation: Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania.
authors.forename: Elena
authors.initials: E
authors.lastname: Igwe
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas, Little Rock, Arkansas.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.affiliation: Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, Virginia.
authors.forename: Kristi R
authors.initials: KR
authors.lastname: Anderson
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Alfred Z
authors.initials: AZ
authors.lastname: Abuhamad
authors.affiliation: Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Cande V
authors.initials: CV
authors.lastname: Ananth
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011248:Pregnancy Complications; D012306:Risk; D016216:Ultrasonography, Prenatal