Download PDF
Am J Perinatol 2014; 31(12): 1093-1104
DOI: 10.1055/s-0034-1371360
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Potential Improvement of Pregnancy Outcome through Prenatal Small for Gestational Age Detection

Bart Jan Voskamp
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
*   These authors contributed equally.
,
Daphne H. Beemsterboer
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
*   These authors contributed equally.
,
Corine J. M. Verhoeven
2   Department of Obstetrics and Gynecology, Maxima Medical Center, Veldhoven, The Netherlands
3   Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
,
Katrien Oude Rengerink
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
,
Anita C. J. Ravelli
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
,
Jannet J. H. Bakker
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
,
Ben Willem J. Mol
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
,
Eva Pajkrt
1   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

27 November 2013

22 January 2014

Publication Date:
28 February 2014 (online)

    Permissions and Reprints

Corrected by:

Erratum to: Potential Improvement of Pregnancy Outcome through Prenatal Small for Gestational Age DetectionAm J Perinatol 2014; 31(12): e1-e1
DOI: 10.1055/s-0034-1373744

Abstract

Objective To assess differences in mode of delivery and pregnancy outcome between prenatally detected and nonprenatally detected small for gestational age (SGA) neonates born at term.

Study Design We performed a retrospective multicenter cohort study. All singleton infants, born SGA in cephalic position between 360/7 and 410/7 weeks gestation, were classified as either prenatally detected SGA or nonprenatally detected SGA. With propensity score matching we created groups with comparable baseline characteristics. We compared these groups for composite adverse perinatal outcome, labor induction, and cesarean section rates.

Results We included 718 SGA infants, of whom 555 (77%) were not prenatally detected. Composite adverse neonatal outcome did not differ statistically significant between the matched prenatally detected and the nonprenatally detected group (5.5 vs. 7.4%, odds ratio [OR] 0.74, 95% confidence interval [CI]: 0.30–1.8). However, perinatal mortality only occurred in the nonprenatally detected group (1.8% [3/163] in the matched cohort, 1.3% [7/555] in the complete cohort). In the propensity matched prenatally detected SGA group both induction of labor (57 vs. 9%, OR 14.0, 95% CI: 7.4–26.2) and cesarean sections (20 vs. 8%, OR 2.9, 95% CI: 1.5–5.8) were more often performed compared with the nonprenatally detected SGA group.

Conclusion Prenatal SGA detection at term allows timely induction of labor and cesarean sections thus potentially preventing stillbirth.

Keywords

small for gestation - prenatal detection - neonatal death - fetal death - induction of labor - propensity score

Note

The registry data are anonymous; therefore no ethical approval was needed. The Netherlands Perinatal Registry has given permission for the analysis of its data, approval number 11.42.


 

  • References

  • 1 Stichting Perinatale Registratie Nederland. Perinatale Zorg in Nederland 2008. Available at: http://www.perinatreg.nl/uploads/150/122/Jaarboek_Zorg_in_Nederland_2008.PDF . Accessed July 01, 2013
    PubMedGoogle Scholar
  • 2 Clausson B, Cnattingius S, Axelsson O. Preterm and term births of small for gestational age infants: a population-based study of risk factors among nulliparous women. Br J Obstet Gynaecol 1998; 105 (9) 1011-1017
    CrossrefPubMedGoogle Scholar
  • 3 Brodszki J, Marsál K. Management of pregnancies with suspected intrauterine growth retardation in Sweden. Results of a questionnaire. Acta Obstet Gynecol Scand 2000; 79 (9) 723-728
    PubMedGoogle Scholar
  • 4 Iams JD. Small for gestational age (SGA) and fetal growth restriction (FGR). Am J Obstet Gynecol 2010; 202 (6) 513
    CrossrefPubMedGoogle Scholar
  • 5 Sheridan RM, Stanek J, Khoury J, Handwerger S. Abnormal expression of transcription factor activator protein-2α in pathologic placentas. Hum Pathol 2012; 43 (11) 1866-1874
    CrossrefPubMedGoogle Scholar
  • 6 Boers KE, Vijgen SMC, Bijlenga D , et al; DIGITAT study group. Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ 2010; 341: c7087
    CrossrefPubMedGoogle Scholar
  • 7 Clausson B, Gardosi J, Francis A, Cnattingius S. Perinatal outcome in SGA births defined by customised versus population-based birthweight standards. BJOG 2001; 108 (8) 830-834
    CrossrefPubMedGoogle Scholar
  • 8 McIntire DD, Bloom SL, Casey BM, Leveno KJ. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med 1999; 340 (16) 1234-1238
    CrossrefPubMedGoogle Scholar
  • 9 Stoknes M, Andersen GL, Dahlseng MO , et al. Cerebral palsy and neonatal death in term singletons born small for gestational age. Pediatrics 2012; 130 (6) e1629-e1635
    CrossrefPubMedGoogle Scholar
  • 10 Pilliod RA, Cheng YW, Snowden JM, Doss AE, Caughey AB. The risk of intrauterine fetal death in the small-for-gestational-age fetus. Am J Obstet Gynecol 2012; 207 (4) e1-e6
    CrossrefPubMedGoogle Scholar
  • 11 Alfirevic Z, Neilson JP. Doppler ultrasonography in high-risk pregnancies: systematic review with meta-analysis. Am J Obstet Gynecol 1995; 172 (5) 1379-1387
    CrossrefPubMedGoogle Scholar
  • 12 Ohel G, Ruach M. Perinatal outcome of idiopathic small for gestational age pregnancies at term: the effect of antenatal diagnosis. Int J Gynaecol Obstet 1996; 55 (1) 29-32
    CrossrefPubMedGoogle Scholar
  • 13 Verlijsdonk JW, Winkens B, Boers K, Scherjon S, Roumen F. Suspected versus non-suspected small-for-gestational age fetuses at term: perinatal outcomes. J Matern Fetal Neonatal Med 2012; 25 (7) 938-943
    CrossrefPubMedGoogle Scholar
  • 14 Visser GHA, Eilers PHC, Elferink-Stinkens PM, Merkus HMWM, Wit JM. New Dutch reference curves for birthweight by gestational age. Early Hum Dev 2009; 85 (12) 737-744
    CrossrefPubMedGoogle Scholar
  • 15 Méray N, Reitsma JB, Ravelli ACJ, Bonsel GJ. Probabilistic record linkage is a valid and transparent tool to combine databases without a patient identification number. J Clin Epidemiol 2007; 60 (9) 883-891
    PubMedGoogle Scholar
  • 16 Schaaf JM, Mol BWJ, Abu-Hanna A, Ravelli ACJ. Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007. BJOG 2011; 118 (10) 1196-1204
    CrossrefPubMedGoogle Scholar
  • 17 Austin PC, Mamdani MM. A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use. Stat Med 2006; 25 (12) 2084-2106
    CrossrefPubMedGoogle Scholar
  • 18 Rubin DB. The design versus the analysis of observational studies for causal effects: parallels with the design of randomized trials. Stat Med 2007; 26 (1) 20-36
    CrossrefPubMedGoogle Scholar
  • 19 Donders ART, van der Heijden GJMG, Stijnen T, Moons KGM. Review: a gentle introduction to imputation of missing values. J Clin Epidemiol 2006; 59 (10) 1087-1091
    CrossrefPubMedGoogle Scholar
  • 20 Normand ST, Landrum MB, Guadagnoli E , et al. Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores. J Clin Epidemiol 2001; 54 (4) 387-398
    CrossrefPubMedGoogle Scholar
  • 21 Hansen BB. Full matching in an observational study of coaching for the SAT. J Am Stat Assoc 2004; 99 (467) 609-618
    CrossrefPubMedGoogle Scholar
  • 22 Hansen BB, Bowers J. Covariate balance in simple, stratified and clustered comparative studies. Stat Sci 2008; 23 (2) 219-236
    CrossrefPubMedGoogle Scholar
  • 23 Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Polit Anal 2007; 15 (3) 199-236
    PubMedGoogle Scholar
  • 24 Ho DE, Imai K, King G, Stuart EA. MatchIt: Nonparametric Preprocessing for Parametric Causal Inference. J Stat Softw 2011; 42 (8) 1-28
    PubMedGoogle Scholar
  • 25 Thoemmes F. Propensity Score Matching in SPSS. Tübingen, Germany: University of Tübingen; 2010. Available at: http://arxiv.org/ftp/arxiv/papers/1201/1201.6385.pdf . Accessed April 14, 2013
    Google Scholar
  • 26 Iacus S, King G, Porro G. CEM: Software for Coarsened Exact Matching. J Stat Softw 2009; 30 (9) 1-27
    PubMedGoogle Scholar
  • 27 Chauhan SP, Beydoun H, Chang E , et al. Prenatal detection of fetal growth restriction in newborns classified as small for gestational age: correlates and risk of neonatal morbidity [published online ahead of print April 16, 2013]. Am J Perinatol . doi:10.1055/s-0033-1343771
    PubMedGoogle Scholar
  • 28 Jahn A, Razum O, Berle P. Routine screening for intrauterine growth retardation in Germany: low sensitivity and questionable benefit for diagnosed cases. Acta Obstet Gynecol Scand 1998; 77 (6) 643-648
    CrossrefPubMedGoogle Scholar
  • 29 Jahn A, Razum O, Berle P. Routine screening for intrauterine growth retardation in Germany: low sensitivity and questionable benefit for diagnosed cases. Acta Obstet Gynaecol Scand 1998; 77: 643-6482
    CrossrefPubMedGoogle Scholar
  • 30 Adams EK, Miller VP, Ernst C, Nishimura BK, Melvin C, Merritt R. Neonatal health care costs related to smoking during pregnancy. Health Econ 2002; 11 (3) 193-206
    CrossrefPubMedGoogle Scholar
  • 31 Adams EK, Melvin CL, Raskind-Hood C, Joski PJ, Galactionova E. Infant delivery costs related to maternal smoking: an update. Nicotine Tob Res 2011; 13 (8) 627-637
    CrossrefPubMedGoogle Scholar
  • 32 Castles A, Adams EK, Melvin CL, Kelsch C, Boulton ML. Effects of smoking during pregnancy. Five meta-analyses. Am J Prev Med 1999; 16 (3) 208-215
    CrossrefPubMedGoogle Scholar
  • 33 DiFranza JR, Lew RA. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. J Fam Pract 1995; 40 (4) 385-394
    PubMedGoogle Scholar
  • 34 Campbell MK, Cartier S, Xie B, Kouniakis G, Huang WY, Han V. Determinants of small for gestational age birth at term. Paediatr Perinat Epidemiol 2012; 26 (6) 525-533
    CrossrefPubMedGoogle Scholar
  • 35 Unterscheider J, Daly S, Geary MP , et al. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study. Am J Obstet Gynecol 2013; 208 (4) e1-e6
    PubMedGoogle Scholar
  • 36 Mongelli M, Ek S, Tambyrajia R. Screening for fetal growth restriction: a mathematical model of the effect of time interval and ultrasound error. Obstet Gynecol 1998; 92 (6) 908-912
    CrossrefPubMedGoogle Scholar
  • 37 Alfirevic Z, Stampalija T, Gyte GML. Fetal and umbilical Doppler ultrasound in normal pregnancy. Cochrane Database Syst Rev 2010; (8) CD001450
    PubMedGoogle Scholar
  • 38 Spong CY, Mercer BM, D'alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol 2011; 118 (2 Pt 1) 323-333
    CrossrefPubMedGoogle Scholar