Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study

Objective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Registry (PRN).Methods. We used data of all nulliparae between 2000 and 2005 with a singleton in cephalic presentation beyond 36+0 weeks, with a birth weight below the 10th percentile. We analysed two groups of pregnancies: (I) with isolated SGA and (II) with both SGA and hypertensive disorders. Onset of labour was related to route of delivery and neonatal outcome.Results. Induction was associated with a higher risk of emergency caesarean section (CS), without improvement in neonatal outcome. For women with isolated SGA the relative risk of emergency CS after induction was 2.3 (95% Confidence Interval [CI] 2.1 to 2.5) and for women with both SGA and hypertensive disorders the relative risk was 2.7 (95% CI 2.3 to 3.1).Conclusion. Induction in pregnancies complicated by SGA at term is associated with a higher risk of instrumental deliveries without improvement of neonatal outcome. Prospective studies are needed to determine the best strategy in suspected IUGR at term.

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Early-Onset Thrombocytopenia in Small-for-Gestational-Age Neonates: A Retrospective Cohort Study

American Journal of Perinatology ◽

10.1055/s-0036-1592382 ◽

2016 ◽

Vol 33 (S 01) ◽

Author(s):

S. Fustolo-Gunnink ◽

R. Vlug ◽

V. Smits-Wintjens ◽

E. Heckman ◽

A. Te Pas ◽

...

Keyword(s):

Cohort Study ◽

Gestational Age ◽

Small For Gestational Age ◽

Retrospective Cohort Study ◽

Early Onset ◽

Retrospective Cohort

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Single-Nucleotide Polymorphisms in the KDR Gene in Pregnancies Complicated by Gestational Hypertensive Disorders and Small-for-Gestational-Age Infants

Reproductive Sciences ◽

10.1177/1933719111428520 ◽

2012 ◽

Vol 19 (5) ◽

pp. 547-554 ◽

Cited By ~ 14

Author(s):

Prabha H. Andraweera ◽

Gustaaf A. Dekker ◽

Steven D. Thompson ◽

Claire T. Roberts

Keyword(s):

Single Nucleotide Polymorphisms ◽

Gestational Age ◽

Small For Gestational Age ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Hypertensive Disorders

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Comparing the Hadlock fetal growth standard to the Eunice Kennedy Shriver National Institute of Child Health and Human Development racial/ethnic standard for the prediction of neonatal morbidity and small for gestational age

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2018.08.011 ◽

2018 ◽

Vol 219 (5) ◽

pp. 474.e1-474.e12 ◽

Cited By ~ 9

Author(s):

Nathan R. Blue ◽

Meghan E. Beddow ◽

Mariam Savabi ◽

Vivek R. Katukuri ◽

Conrad R. Chao

Keyword(s):

Child Health ◽

Human Development ◽

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Morbidity ◽

Growth Standard ◽

Racial Ethnic

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Placental pathology and neonatal outcome in small for gestational age pregnancies with and without abnormal umbilical artery Doppler flow

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2018.01.009 ◽

2018 ◽

Vol 222 ◽

pp. 52-56 ◽

Cited By ~ 5

Author(s):

Hadas Ganer Herman ◽

Elad Barber ◽

Rose Gasnier ◽

Liat Gindes ◽

Jacob Bar ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Umbilical Artery ◽

Neonatal Outcome ◽

Placental Pathology ◽

Doppler Flow ◽

Umbilical Artery Doppler

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Heart Failure in Women With Hypertensive Disorders of Pregnancy

Hypertension ◽

10.1161/hypertensionaha.120.15654 ◽

2020 ◽

Vol 76 (5) ◽

pp. 1506-1513 ◽

Cited By ~ 2

Author(s):

Michael C. Honigberg ◽

Hilde Kristin Refvik Riise ◽

Anne Kjersti Daltveit ◽

Grethe S. Tell ◽

Gerhard Sulo ◽

...

Keyword(s):

Heart Failure ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Gestational Hypertension ◽

Hazard Ratio ◽

Hypertensive Disorders Of Pregnancy ◽

First Birth ◽

Hypertensive Disorders

Hypertensive disorders of pregnancy (HDP) have been associated with heart failure (HF). It is unknown whether concurrent pregnancy complications (small-for-gestational-age or preterm delivery) or recurrent HDP modify HDP-associated HF risk. In this cohort study, we included Norwegian women with a first birth between 1980 and 2004. Follow-up occurred through 2009. Cox models examined gestational hypertension and preeclampsia in the first pregnancy as predictors of a composite of HF-related hospitalization or HF-related death, with assessment of effect modification by concurrent small-for-gestational-age or preterm delivery. Additional models were stratified by final parity (1 versus ≥2 births) and tested associations with recurrent HDP. Among 508 422 women, 565 experienced incident HF over a median 11.8 years of follow-up. After multivariable adjustment, gestational hypertension in the first birth was not significantly associated with HF (hazard ratio, 1.41 [95% CI, 0.84–2.35], P =0.19), whereas preeclampsia was associated with a hazard ratio of 2.00 (95% CI, 1.50–2.68, P <0.001). Among women with HDP, risks were not modified by concurrent small-for-gestational-age or preterm delivery ( P interaction =0.42). Largest hazards of HF were observed in women whose only lifetime birth was complicated by preeclampsia and women with recurrent preeclampsia. HF risks were similar after excluding women with coronary artery disease. In summary, women with preeclampsia, especially those with one lifetime birth and those with recurrent preeclampsia, experienced increased HF risk compared to women without HDP. Further research is needed to clarify causal mechanisms.

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Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

American Journal of Perinatology ◽

10.1055/s-0039-1696640 ◽

2019 ◽

Author(s):

Annie M. Dude ◽

William Grobman ◽

David Haas ◽

Brian M. Mercer ◽

Samuel Parry ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Gestational Age ◽

Small For Gestational Age ◽

Pregnancy Outcomes ◽

Large For Gestational Age ◽

Gestational Weight ◽

Excessive Gestational Weight Gain ◽

Hypertensive Disorders

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

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High Fetal Fraction on First Trimester Cell-Free DNA Aneuploidy Screening and Adverse Pregnancy Outcomes

American Journal of Perinatology ◽

10.1055/s-0039-1694005 ◽

2019 ◽

Vol 37 (01) ◽

pp. 008-013 ◽

Cited By ~ 4

Author(s):

Lydia L. Shook ◽

Mark A. Clapp ◽

Penelope S. Roberts ◽

Sarah N. Bernstein ◽

Ilona T. Goldfarb

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

First Trimester ◽

Hypertensive Disorders Of Pregnancy ◽

Aneuploidy Screening ◽

Hypertensive Disorders ◽

Increased Risk ◽

Adverse Pregnancy ◽

Fetal Fraction

Abstract Objective To test the hypothesis that high fetal fraction (FF) on first trimester cell-free deoxyribonucleic acid (cfDNA) aneuploidy screening is associated with adverse perinatal outcomes. Study Design This is a single-institution retrospective cohort study of women who underwent cfDNA screening at <14 weeks' gestation and delivered a singleton infant between July 2016 and June 2018. Women with abnormal results were excluded. Women with high FF (≥95th percentile) were compared with women with normal FF (5th–95th percentiles). Outcomes investigated were preterm birth, small for gestational age, and hypertensive disorders of pregnancy. Results A total of 2,033 women met inclusion criteria. The mean FF was 10.0%, and FF >16.5% was considered high (n = 102). Women with high FF had a greater chance of delivering a small for gestational age infant <fifth percentile, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.1–4.8, p = 0.039). There was no significant association between high FF and either preterm birth or hypertensive disorders of pregnancy. Conclusion Women with a high FF in the first trimester are at increased risk of delivering a small for gestational age infant <fifth percentile. Further investigation into the clinical implications of a high FF is warranted.

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