The small-for-gestational-age infant: obstetrical management and perinatal outcome

In order to study whether antenatal detection and supervision of small for-gestational-age (SGA) infants favours the prognosis, the obstetrical management and perinatal outcomes of all SGA infants born in Uppsala county between 1980 and 1985 were reviewed. Data on 154 mothers and their well-shaped, single-born SGA infants (less than -2 SD) were analysed. Twenty-three mothers delivering SGA infants were admitted to the hospital due to maternal diseases ("complicated SGA pregnancies"). Fetal well-being was regularly monitored in all these pregnancies. In the symptom-free SGA pregnancies (n = 131), fetal well-being was regularly monitored in 69 pregnancies whereas in 62 it was not. There were eight stillborn SGA infants. These infants were all delivered by mothers with symptom-free pregnancies, not supervised with regard to fetal well-being. In the neonatal period, 15 SGA infants either suffered from postpartal asphyxia (Apgar 5' less than 7) or from a severe disease (meconium aspiration, convulsions, idiopathic respiratory distress syndrome or septicemia). Seven SGA infants (of whom two died postnatally) delivered by mothers with complicated pregnancies and eight SGA infants not supervised with regard to fetal well-being during pregnancy, suffered from one or more of these complications. In symptom-free SGA pregnancies, regularly supervised with regard to fetal well-being, all SGA infants (n = 69) escaped these severe neonatal problems.