EP18.19: Abdominal circumference growth velocity as an independent predictor of small‐for‐gestational‐age fetuses and the relationship with adverse perinatal outcomes

Objective: This study aimed to assess reduced fetal growth between 35 weeks of gestation and birth in non-small for gestational age fetuses associated with adverse perinatal outcomes (APOs). Material and Method: It is a retrospective cohort study of 9,164 non-small for gestational age fetuses estimated by ultrasound at 35 weeks. The difference between the birth weight percentile and the estimated percentile weight (EPW) at 35 weeks of gestation was calculated, and we studied the relationship of this difference with the appearance of APO. APOs were defined as cesarean or instrumental delivery rates for nonreassuring fetal status, 5-min Apgar score <7, arterial cord blood pH <7.10, and stillbirth. Fetuses that exhibited a percentile decrease between both moments were classified into 6 categories according to the amount of percentile decrease (0.01–10.0, 10.01–20.0, 20.01–30.0, 30.01–40.0, 40.01–50.0, and >50.0 percentiles). It was evaluated whether the appearance of APO was related to the amount of this percentile decrease. Relative risk (RR) was calculated in these subgroups to predict APOs in general and for each APO in particular. Receiver operating characteristic and area under curves (AUC) for the difference in the percentile was calculated, used as a continuous parameter in the entire study population. Results: The median gestational age at delivery in uncomplicated pregnancies was 40.0 (39.1–40.7) and in pregnancies with APOs 40.3 (49.4–41.0), p < 0.001. The prevalence of APOs was greater in the group of fetuses with a decrease in percentile (7.6%) compared to those with increased percentile (4.8%) (p < 0.001). The RR was 1.63 (95% CI: 1.365–1.944, p < 0.001). Although the differences were significant in all decreased percentile groups, RRs were significantly higher when decreased growth values were >40 points (RR: 2.036, 95% CI: 1.581–2.623, p < 0.001). The estimated value of the AUC for percentile decrease was 0.58 (0.56–0.61, p < 0.001). Conclusion: Fetuses with a decrease in the EPW between the ultrasound at 35 weeks of gestation and birth have a higher risk of APOs, being double in fetuses with a decrease of >40 percentile points.

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Using fetal abdominal circumference growth velocity in the prediction of adverse outcome in near-term small-for-gestational-age fetuses

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.18988 ◽

2018 ◽

Vol 52 (4) ◽

pp. 494-500 ◽

Cited By ~ 7

Author(s):

A. Cavallaro ◽

M. Veglia ◽

E. Svirko ◽

S. Vannuccini ◽

G. Volpe ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Growth Velocity ◽

Adverse Outcome ◽

Abdominal Circumference ◽

Near Term

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Benefits of not smoking during pregnancy for Australian Aboriginal and Torres Strait Islander women and their babies: a retrospective cohort study using linked data

BMJ Open ◽

10.1136/bmjopen-2019-032763 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032763 ◽

Cited By ~ 1

Author(s):

Carol McInerney ◽

Ibinabo Ibiebele ◽

Jane B Ford ◽

Deborah Randall ◽

Jonathan M Morris ◽

...

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Lower Risk ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Smoking During Pregnancy ◽

Relative Risks ◽

South Wales ◽

Adverse Perinatal Outcomes

ObjectivesTo provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with Aboriginal mothers who reported smoking during pregnancy.DesignPopulation based retrospective cohort study using linked data.SettingNew South Wales, the most populous Australian state.Population18 154 singleton babies born to 13 477 Aboriginal mothers between 2010 and 2014 were identified from routinely collected New South Wales datasets. Aboriginality was determined from birth records and from four linked datasets through an Enhanced Reporting of Aboriginality algorithm.ExposureNot smoking at any time during pregnancy.Main outcome measuresUnadjusted and adjusted relative risks (aRR) and 95% CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks.ResultsCompared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95% CI 0.44 to 0.76), preterm birth (aRR=0.58, 95% CI 0.53 to 0.64) and small-for-gestational age (aRR=0.35, 95% CI 0.32 to 0.39). PAFs (%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n=8919), those who did not smoke (n=9235) had a lower risk of being transferred to another hospital (aRR=0.76, 95% CI 0.66 to 0.89).ConclusionsBabies born to women who did not smoke during pregnancy had a lower risk of adverse perinatal outcomes. Rates of adverse outcomes among Aboriginal non-smokers were similar to those among the general population. These results quantify the proportion of adverse perinatal outcomes due to smoking and highlight why effective smoking cessation programme are urgently required for this population.

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P20.07: Abdominal circumference growth velocity and cerebroplacental ratio as predictors of perinatal outcome in small-for-gestational-age fetuses

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.18203 ◽

2017 ◽

Vol 50 ◽

pp. 220-220

Author(s):

A. Cavallaro ◽

S. Vannuccini ◽

G. Volpe ◽

S. Ruiz-Martinez ◽

C. Ioannou ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Growth Velocity ◽

Perinatal Outcome ◽

Abdominal Circumference ◽

Cerebroplacental Ratio

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OP13.03: Prediction of delivery of small-for-gestational age neonates and adverse perinatal outcomes by angiogenic factors at 37 weeks' gestation

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17812 ◽

2017 ◽

Vol 50 ◽

pp. 88-89

Author(s):

S. Triunfo ◽

A. Arranz ◽

V. Sureda-Rodriguez ◽

C. Dominguez ◽

E. Gratacós ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

Angiogenic Factors ◽

Adverse Perinatal Outcomes

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631Benefits of not smoking during pregnancy for Aboriginal women and their babies

International Journal of Epidemiology ◽

10.1093/ije/dyab168.664 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Siranda Torvaldsen ◽

Ibinabo Ibiebele ◽

Jane Ford ◽

Deborah Randall ◽

Jonathan Morris ◽

...

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Lower Risk ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Smoking During Pregnancy ◽

Relative Risks ◽

Aboriginal Women ◽

Adverse Perinatal Outcomes

Abstract Background To provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with those who reported smoking. Methods This population-based retrospective cohort study used linked data from routinely collected datasets. Not smoking during pregnancy was the exposure of interest among all New South Wales Aboriginal women who became mothers of singleton babies in 2010–2014. Unadjusted and adjusted relative risks (aRR) and 95%CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks. Results Compared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95%CI 0.44–0.76), preterm birth (aRR=0.58, 95%CI 0.53–0.64) and small-for-gestational age (aRR=0.35, 95%CI 0.32–0.39). PAFs(%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n = 8,919), those who did not smoke (n = 9,235) had a lower risk of being transferred to another hospital (aRR=0.76, 95%CI 0.66–0.89). Conclusions Babies born to women who did not smoke had much lower risks of all adverse perinatal outcomes. Key messages Between a quarter and a half of adverse perinatal outcomes in this population could potentially be prevented by an effective smoking cessation program.

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Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus

Frontiers in Pediatrics ◽

10.3389/fped.2021.741793 ◽

2021 ◽

Vol 9 ◽

Author(s):

Juncao Chen ◽

Huimin Xiao ◽

Yong Yang ◽

Yaping Tang ◽

Xiaoqi Yang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

First Year ◽

Retrospective Case ◽

Adverse Perinatal Outcomes ◽

First Year Of Life

We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23–2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05–4.00] and [1.05–16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33–8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55–3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25–25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18–2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

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