Human<em> in utero</em> growth restriction (IUGR) is associated with an increased risk for perinatal mortality and morbidity<br />among newborns and infants. To pursue this challenge, a Request For Proposals (RFP) was issued in 1983<br />by The U.S. Epidemiology and Biometry Research Program at the National Institute of Child Health and Human<br />Development (NICHD). A consortium was set up at the universities and university hospitals in Trondheim,<br />Bergen (Norway) and Uppsala (Sweden) and was funded by the NICHD to conduct the <em>Scandinavian Successive</em><br /><em>Small-for-Gestational Age (SGA) pregnancy and birth outcome study</em>. The study design included a comprehensive<br />biobank with maternal and cord serum samples, placental tissue, and a multitude of data collected from<br />interviews, questionnaires, and clinical examinations.<br /> The SGA cohort study involved 6,354 Caucasian pregnant women in the three study sites who expected their<br />second or third child from 1986-88. The study women were screened in early second trimester and mothers who<br />had an increased risk to deliver a smaller than expected newborn were followed in detail through the second half<br />of pregnancy and at birth. Selected children were screened several times through their first and up to five years<br />of age. Moreover, a highly selected subgroup in Trondheim has been followed at 14, 19, and 26 years’ age.<br /> Almost thirty years later, we have searched the body of scientific publications that originated from this cohort<br />study in an attempt to assess if and to what extent the main aims and objectives were achieved and to summarize<br />the overall outcomes. The SGA cohort has resulted in close to 100 published papers in peer reviewed journals<br />and some 40 graduate and undergraduate degrees. Risk factors of SGA, like maternal smoking, low prepregnancy<br />weight and education attainment, and a previous SGA birth outcome were confirmed. Conversely, no<br />totally new and unknown risk factors were identified. Serial ultrasound measures have enabled a distinction<br />between SGA with restricted and normal intrauterine growth, and has further indicated that being born SGA is<br />mainly a problem in combination with IUGR. Further, the consequences of IUGR are more pronounced at<br />adolescence and young adulthood than at five years of age.<br /> An increased understanding of the pathogenesis of different categories of growth restriction is essential to<br />recognize and diagnose IUGR properly, and to reduce the perinatal mortality and morbidity from SGA. Moreover,<br />SGA is a significant predictor at follow-up of the child. An up to date biobank has ensured the quality of data<br />and biological samples, and has been crucial for the outcome of the entire SGA study. It continues to be a<br />valuable resource in future research.
The Association Between Small-for-Gestational Age Triplet Pregnancies and Neonatal Mortality: A Novel Approach to Growth Assessment in Multiple Gestations
