Adverse pregnancy outcome and association with small for gestational age birthweight by customized and population-based percentiles

Objective The objective of the study was to investigate the association between pregnancy complications and small for gestational age (SGA) birthweight, comparing SGA based on the customized growth potential with SGA based on the birthweight standard of the same population. Study Design This was a r...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2009-07, Vol.201 (1), p.28.e1-28.e8
Main Authors: Gardosi, Jason, MD, FRCOG, Francis, Andre, MSc
Format: Article
Language:English
Subjects:
Biological and medical sciences
Birth Weight
birthweight
customized growth charts
Diseases of mother, fetus and pregnancy
Female
fetal growth
Gestational Age
growth potential
Gynecology. Andrology. Obstetrics
Humans
Hypertension, Pregnancy-Induced - epidemiology
Infant, Newborn
Infant, Small for Gestational Age - physiology
Medical sciences
Obesity - epidemiology
Obstetric Labor, Premature - epidemiology
Obstetrics and Gynecology
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Outcome
Pregnancy. Fetus. Placenta
Reference Values
Retrospective Studies
Stillbirth - epidemiology
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Summary:Objective The objective of the study was to investigate the association between pregnancy complications and small for gestational age (SGA) birthweight, comparing SGA based on the customized growth potential with SGA based on the birthweight standard of the same population. Study Design This was a retrospective analysis of a database from a US multicenter study. Pregnancy complications included threatened preterm labor, antepartum hemorrhage, pregnancy-induced hypertension, preeclampsia, stillbirth, and early neonatal death. Results Compared with SGA by the birthweight standard, SGA by customized growth potential showed higher risk for each of the 6 adverse indicators. A third of the SGA group was small by customized centiles but not by population-based centiles, yet was strongly associated with each of the pregnancy complications studied. This subgroup of unrecognized SGA babies included 26% preterm deliveries. In contrast, a subgroup that was SGA by the population standard but not by the customized standard (17.2%), was not associated with any of the indicators of adverse outcome. Conclusion SGA defined by customized growth potential improves the differentiation between physiologically and pathologically small babies.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2009.04.034