The risk of intrauterine fetal death in the small-for-gestational-age fetus

Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR. Electronic address: .
American journal of obstetrics and gynecology (Impact Factor: 4.7). 10/2012; 207(4):318.e1-6. DOI: 10.1016/j.ajog.2012.06.039
Source: PubMed

ABSTRACT We sought to evaluate the risk of intrauterine fetal death (IUFD) in small-for-gestational-age (SGA) fetuses.
We analyzed a retrospective cohort of all births in the United States in 2005, as recorded in a national database. We calculated the risk of IUFD within 3 sets of SGA threshold categories as well as within non-SGA pregnancies using the number of at-risk fetuses as the denominator.
The risk of IUFD increased with gestational age and was inversely proportional to percentile of birthweight for gestational age. The risk for IUFD in those <3rd percentile was as high as 58.0 IUFDs per 10,000 at-risk fetuses, 43.9 for <5th percentile, and 26.3 for <10th percentile compared to 5.1 for non-SGA gestations.
There is an increase in the risk of IUFD in SGA fetuses compared to non-SGA fetuses at all gestational ages with the greatest risk demonstrated in the lowest percentile cohort evaluated.

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    • "Types of placentas Central Peripheral Paracentral Battledore Velamentous Number (%) 343/528 (65.0) 136/528 (25.8) 44/528 (8.3) 5/528 (0.95) 95% CI [60–70] [21–33] [5–16] [0] [1] [2] [3] [4] [5] [6] [7] [8] [9] "
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    BioMed Research International 05/2014; 2014:341251. DOI:10.1155/2014/341251 · 3.17 Impact Factor
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    • "The findings from this study are consistent with previous studies showing that at or close to term, the benefit of each increased week of gestation is greater than the respiratory benefit of fetal exposure to labour [2,32]. Each additional week of gestation does present some risk of intrauterine death, however for births where the infant is ≥10th percentile for size the risk of intrauterine death at 37 and 38 weeks is less than 2 per 10,000 ongoing pregnancies [33]. "
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    • "Whereas SGA is commonly defined on the 10th centile of birthweight (Alexander et al., 1996), we used the narrower threshold of the 5th centile so that the mean prevalence of SGA was comparable to that of preterm (mean of 57 per 1000 in the study area), so that analyses of the two birth outcomes would share similar statistical power. Many previous studies have used the 5th centile of birthweight as an indicator of SGA (Abeysena, Jayawardana, & Seneviratne, 2009; Khashan, Baker, & Kenny, 2010; Pilliod, Cheng, Snowden, Doss, & Caughey, 2012; Zhang & Harville, 1998). As national centiles for SGA were unavailable for gestations prior to 24 completed weeks, all births before 24 weeks gestation were excluded. "
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