| Risk of Morbid Perinatal Outcomes in Small-for-Gestational-Age Pregnancies: Customized Compared With Conventional Standards of Fetal Growth. | |
| | |
MedLine Citation:
|
PMID: 22183207 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVE: : To estimate and compare the risk of morbid perinatal outcomes in pregnancies identified as small for gestational age (SGA) with customized compared with conventional standards of fetal growth. METHODS: : Ultrasound-derived estimates of fetal weight were used to generate a fetal growth trajectory (N=7,510). The gestational age at delivery and pathologic and physiologic variables from 5,072 pregnancies were used to calculate a customized threshold for SGA. In a separate analysis of 32,070 pregnancies, rates of morbid outcomes were compared in participants classified as SGA according to a population-based birth weight standard only (SGApop only), a customized standard only (SGAcust only), and both methods (SGAboth). RESULTS: : Eight-hundred seventy-five (2.7%) participants were SGApop only, 1,970 (6.1%) participants were SGAboth, and 609 (1.9%) participants were SGAcust only. The odds ratios of neonatal death in SGApop only and SGAcust only pregnancies were 1.78 (95% confidence interval [CI] 0.2-13.1) and 54.6 (95% CI 29.0-102.8), respectively. Rates of prematurity in the SGApop only and SGAcust only cohorts were 4.8% and 64.5%, respectively. After adjustment for the effect of prematurity, odds ratios of neonatal death in the SGApop only and SGAcust only cohorts were 4.8 (95% CI 0.6-37.0) and 2.9 (95% CI 1.4-6.1), respectively. CONCLUSION: : After adjustment for confounding stemming from premature delivery, there is little difference in the risk of adverse outcomes between SGAcust only and SGApop only participants. Adoption of customized fetal growth standards into clinical practice may not improve the ability to identify pregnancies with increased risk of perinatal morbidity. LEVEL OF EVIDENCE: : II. |
| | |
Authors:
|
Jacob C Larkin; Lyndon M Hill; Paul D Speer; Hyagriv N Simhan |
Related Documents
:
|
21895537 - Splitting of the umbilical cord in a 13 week fetus. 22199137 - Evaluation of transplacental treatment for fetal congenital bradyarrhythmia. 22177177 - Is intracytoplasmic sperm injection overused? 21778757 - Thyroid disease in pregnancy. 452867 - Pregnancy complications following legally induced abortion with special reference to ab... 15138817 - Placental pathology: its impact on explaining prenatal and perinatal death. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Obstetrics and gynecology Volume: 119 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2012 Jan |
Date Detail:
|
Created Date: 2011-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
|
Languages: eng Pagination: 21-7 Citation Subset: AIM; IM |
Affiliation:
|
From the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Rhesus monkeys (Macaca mulatta) show robust evidence for memory awareness across multiple generaliza...
Next Document: Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial.