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Postterm infants: too big or too small?

F H McLean1, M E Boyd, R H Usher

  • 1Department of Obstetrics and Gynecology, McGill University Faculty of Medicine, Montreal, Quebec, Canada.

American Journal of Obstetrics and Gynecology
|February 1, 1991
PubMed
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Postterm pregnancy concerns have shifted. Accurate dating via ultrasonography reveals fetal growth, suggesting macrosomia risk rather than intrauterine growth retardation in prolonged gestations.

Area of Science:

  • Perinatology
  • Fetal Development
  • Obstetrics

Background:

  • Historical concerns in postterm pregnancy focused on difficult delivery of large fetuses.
  • Shift in concern towards intrauterine fetal demise, particularly in small-for-date fetuses.
  • Previous studies may be limited by inaccurate gestational dating without early ultrasonography.

Purpose of the Study:

  • To reassess fetal growth patterns in postterm pregnancies.
  • To clarify risks associated with prolonged gestation using accurate dating methods.
  • To evaluate fetal development between 273 and 300 days of gestational age.

Main Methods:

  • Study included 7000 infants.
  • Gestational age confirmed by early ultrasonography (+/- 7 days).

Related Experiment Videos

  • Analysis of birth weight, crown-heel length, and head circumference.

    • Main Results:

    • Demonstrated a gradual increase in birth weight, crown-heel length, and head circumference.
    • Observed growth between 273 and 300 days of gestational age.
    • No evidence of postterm weight loss or reduced weight for length was found.

    Conclusions:

    • Postterm pregnancy management should prioritize concerns of fetal macrosomia.
    • Intrauterine growth retardation is not a primary concern in accurately dated postterm pregnancies.
    • Ultrasonography is crucial for accurate dating and reassessment of fetal growth in postterm cases.