Effects of antenatal recognition and follow‐up on perinatal outcomes in small‐for‐gestational age infants delivered after 36 weeks

Fratelli, N.; Valcamonico, Adriana; Prefumo, Federico; Pagani, G.; Guarneri, Tiziana; Frusca, T.

doi:10.1111/aogs.12020

Cited by 35 publications

(55 citation statements)

References 24 publications

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“…These results from the French context are concordant with previous studies which also documented low detection rates for SGA . One reason may be that the effectiveness of ultrasound and symphysis–fundal height measurement for the detection of FGR is poor .…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies of antenatal detection of FGR came from selected hospitals or covered a limited geographical zone . Further, these studies only included SGA infants . Our study made it possible to quantify the proportions of non‐SGA infants suspected of FGR during pregnancy and to investigate their obstetric management and neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Existing studies have found that only between 10% and 36% of infants with a birthweight under the 10th percentile are detected during pregnancy . However, many studies reflect practices in single centres only and several are over 10 years old . Of more concern, however, is the fact that these studies do not include normal birthweight infants.…”

Section: Introductionmentioning

confidence: 99%

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Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Monier

Blondel

Ego

et al. 2014

BJOG

148

105

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Objective To assess the proportion of small for gestational age (SGA) and normal birthweight infants suspected of fetal growth restriction (FGR) during pregnancy, and to investigate obstetric and neonatal outcomes by suspicion of FGR and SGA status at birth.Design Population-based study.Setting All French maternity units in 2010.Population Representative sample of singleton births (n = 14 100).Methods We compared SGA infants with a birthweight of less than the 10th percentile suspected of FGR, defined as mention of FGR in medical charts (true positives), non-SGA infants suspected of FGR (false positives), SGA infants without suspicion of FGR (false negatives) and non-SGA infants without suspicion of FGR (true negatives). Multivariable analyses were adjusted for maternal and neonatal characteristics hypothesised to affect closer surveillance for FGR and our outcomes.Main outcome measures Obstetric management (caesarean, provider-initiated preterm and early term delivery) and neonatal outcomes (late fetal death, preterm birth, Apgar score, resuscitation at birth).Results 21.7% of SGA infants (n = 265) and 2.1% of non-SGA infants (n = 271) were suspected of FGR during pregnancy. Compared with true negatives, provider-initiated preterm deliveries were higher for true and false positives (adjusted risk ratio [aRR], 6.1 [95% CI,.7]), but not for false negatives (aRR, 1.1 [95% CI, 0.6-1.9]). Neonatal outcomes were not better for SGA infants if FGR was suspected.Conclusion Antenatal suspicion of FGR among SGA infants was low and one-half of infants suspected of FGR were not SGA. The increased risk of provider-initiated delivery observed in non-SGA infants suspected of FGR raises concerns about the iatrogenic consequences of screening.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Monier

Blondel

Ego

et al. 2014

BJOG

148

105

View full text Add to dashboard Cite

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“…It was detected as frequently as 69.5% in our study, it might have been arisen because the diagnoses of SGA were made antenatally. Likewise, Fratelli et al showed that cesarean delivery rates of women who were diagnosed antenatally as they had SGA babies were significantly higher than women who were diagnosed in postpartum period (8).…”

Section: Discussionmentioning

confidence: 99%

Are Leukocyte and Platelet Indices Associated with Small for Gestational Age Birth and/or Oligohydramnios?

Ersoy¹,

Özler²,

Öztaş³

et al. 2016

Acta Med Anatol

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Introduction:To investigate whether certain leukocyte and platelet indices predict Small for Gestational Age (SGA) birth and/ or oligohydramnios. Materials and Methods:In this retrospective study, 408 pregnant women were included, who didn't have foreknown systemic diseases and other risk factors like drug use, smoking. Patients diagnosed with SGA birth (Group-I, n=59), SGA birth and oligohydramnios (Group-II, n=46), solely oligohydramnios (Group-III, n=23) and control group (Group-IV, n=280, matched for maternal age and body mass index) were selected from medical records. Leukocyte and platelet indices in first trimester and third trimester, demographic and obstetric data were obtained from medical records. Then, groups were compared.Results: Maternal ages and body mass indices were similar among groups. Total leukocyte, neutrophil, lymphocyte and platelet counts, platelet indices (p<0.001), neutrophil to lymphocyte ratios (p<0.001) were significantly different between first and third trimester values in all patients. Platelet distribution width values of group-II in both trimester were significantly higher than ones of group-IV. Conclusion:Most hematologic parameters were not associated with SGA birth and/or oligohydramnios, but it was clarified that they differ significantly between first and third trimester. A new prospective study with larger sample size may present more definitive results.

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“…Late‐onset FGR is also associated with increased perinatal morbidity in the form of fetal distress, hypoglycemia, seizures, behavioral problems, cerebral palsy and cardiovascular disease. There are, however, other potential risks, including increased NNU admission, childhood morbidity and ‘medicalization’. What are not clear are the respective roles of GA at delivery, birth weight or pregnancy characteristics associated with early‐term delivery.…”

Section: Discussionmentioning

confidence: 99%

Small‐for‐gestational‐age babies after 37 weeks: impact study of risk‐stratification protocol

Veglia

Cavallaro

Papageorghiou

et al. 2018

Ultrasound in Obstet & Gyne

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Effects of antenatal recognition and follow‐up on perinatal outcomes in small‐for‐gestational age infants delivered after 36 weeks

Abstract: Antenatal recognition of late SGA may improve perinatal outcomes. However, admission to neonatal intensive care and cesarean delivery were more frequent among SGA infants recognized antenatally.

Cited by 35 publications

References 24 publications

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Are Leukocyte and Platelet Indices Associated with Small for Gestational Age Birth and/or Oligohydramnios?

Small‐for‐gestational‐age babies after 37 weeks: impact study of risk‐stratification protocol

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