title: Small for gestational age newborns--does pre-recognition make a difference in pregnancy outcome?
abstract: OBJECTIVE
  We aimed to evaluate whether pre-recognition of small for gestational age (SGA) at late preterm or term pregnancies, has an impact on pregnancy outcome.
  
  
  METHODS
  Retrospective analysis of SGA newborns, stratified to those with suspected or unsuspected IUGR according the sonographic estimated fetal weight (EFW), below the 10th percentile for gestational age (n = 619), with fetuses not suspected as SGA (EFW ≥10th percentile) preformed up to 7 days prior to delivery (n = 1770).
  
  
  RESULTS
  SGA was correctly diagnosed prior to delivery in 26% of the fetuses. Women with suspected SGA were delivered earlier (37.9 ± 1.7 versus 38.8 ± 1.4 weeks, p < 0.001) and at a lower birth weight (2280 ± 321 versus 2454 ± 263 grams, p < 0.001). They also had higher rates of induction of labor (19.1% versus 6.2%, p < 0.001) and cesarean delivery (29.1% versus 19.8%, p < 0.001). Fetuses suspected for SGA had higher rate of neonatal adverse outcome, but on multivariate analysis suspected SGA (aOR 0.41, 95% CI 0.20-0.86), birthweight (aOR 0.67, 95% CI 0.5 to -0.77 for each additional 50 g), gestational age at delivery (aOR 0.63, 95% CI 0.56-0.71 for each additional week) and spontaneous vaginal delivery (aOR 0.88, 95% CI 0.19-3.89) were independently associated with an improved neonatal composite outcome.
  
  
  CONCLUSIONS
  Identification of SGA may improve neonatal outcome. However, by itself, it is not an indication for intervention, which may lead to adverse outcome.
authors.affiliation: a Rabin Medical Center, Helen Schneider Hospital for Women , Petah Tikva , Israel and.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.forename: Ron
authors.initials: R
authors.lastname: Bardin
authors.forename: Israel
authors.initials: I
authors.lastname: Meizner
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000592:standards / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adverse pregnancy outcome; small for gestational age; sonographic estimated fetal weight; ultrasound