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Influential and prognostic factors of small for gestational age infants
Yong-li Zhang1, Jun-tao Liu, Jin-song Gao
1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Insights
Small for gestational age (SGA) infants face higher risks of complications and long-term health issues. Maternal factors like parity and hyperthyroidism, along with specific fetal abdominal circumferences, are key indicators for SGA.
Area of Science:
- Perinatal Medicine
- Neonatology
- Maternal-Fetal Medicine
Background:
- Small for gestational age (SGA) infants are linked to increased risks of stillbirth, neonatal complications (e.g., polycythemia, hyperbilirubinemia), and long-term neurologic and cardiovascular issues.
- Effective prenatal monitoring and management are crucial for SGA pregnancies.
- Identifying influential and prognostic factors for SGA infants is essential for improving outcomes.
Purpose of the Study:
- To investigate the factors influencing and predicting the development of small for gestational age (SGA) infants.
- To identify key maternal and fetal characteristics associated with SGA.
- To establish reliable indicators for early detection of SGA.
Main Methods:
- A retrospective study comparing 55 SGA infants with 122 appropriate for gestational age (AGA) infants from January 2001 to June 2007.
- Data collected included maternal demographics, pregnancy details, ultrasound measurements (uterine height, abdominal circumference), and neonatal outcomes.
- Multivariate analysis was used to identify significant risk factors and prognostic indicators.
Main Results:
- Significant differences were found in placenta weight and the incidence of neonatal malformations between SGA and AGA groups.
- Increased parity, maternal hyperthyroidism, and a history of hyperthyroidism were identified as significant risk factors for SGA.
- Fetal abdominal circumference measurements below 30 cm at 32 weeks and 32 cm at 38 weeks showed a high Youden index (0.62) for predicting SGA.
Conclusions:
- SGA infants are associated with smaller placentas and a higher likelihood of malformations.
- Elevated parity, maternal hyperthyroidism, and a history of hyperthyroidism are confirmed risk factors for SGA.
- Fetal abdominal circumference, measured via ultrasonography, serves as an effective predictive index for SGA at specific gestational ages.
Background:
Small for gestational age (SGA) infants are associated with a high rate of oligohydramnios, stillbirth and cesarean delivery. Among SGA patients there is a higher risk of neonatal complications, such as polycythemia, hyperbilirubinemia, and hypothermia. Additionally, the SGA infant is prone to suffer from major neurologic sequelae, as well as cardiovascular system disease, in later life. Proper monitoring and therapy during pregnancy are, therefore, of utmost importance. The present study aimed to investigate the influential and prognostic factors of SGA infants.
Methods:
From January 2001 to June 2007, a total of 55 SGA neonatal infants were included in a study group. All were born at Peking Union Medical College Hospital, with regular formal antenatal examinations. In addition, a total of 122 cases of appropriate for gestational age (AGA) infants were born at the same time and were registered into a control group. All cases were singleton pregnancies with detailed information of the maternal age, gravidity, parity, maternal height and weight, complications, uterine height and abdominal circumference, results from transabdominal ultrasonography between 32 - 38 gestational weeks, pregnancy duration, delivery manner, placenta, umbilical cord, and neonatal complications.
Results:
Significant differences were observed in placenta weight and neonatal malformations between the study and control groups. Multivariate analysis revealed increased parity, maternal hyperthyroidism and hyperthyroidism history as risk factors. Fetal abdominal circumferences less than 30 and 32 cm at 32 - 38 gestational weeks respectively, as determined by ultrasonography, resulted in a Youden index of 0.62.
Conclusions:
SGA infants were associated with a greater risk of smaller placentas and infant malformations. Increased parity, maternal hyperthyroidism, and a hyperthyroid history were risk factors for SGA infants. Fetal abdominal circumference less than 30 cm at 32 gestational weeks and less than 32 cm at 38 weeks, as determined by ultrasonography, was considered an effective index for SGA.
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