Prevalence, Risk Factors and Outcomes of Pregnancies with Small for Gestational Age Fetus at BPKIHS

Introduction: Small-for-gestational-age (SGA) is defined by a birth weight below the 10th percentile for mean weight corrected for gestational age. It is associated with adverse health events throughout life, including substantial perinatal morbidity and mortality rates. Objectives: The aims of the study was to estimate the prevalence of the SGA newborns, attributable factors for SGA and perinatal outcomes of SGA. Methodology: A hospital based prospective cohort study was conducted among pregnant women after 28 weeks' gestational age in the Department of Obstetrics and Gynaecology, BPKIHS, Dharan from October, 2016 to June, 2017.A total of 150 study population was sampled using purposive sampling technique whose symphysio-fundal height lags the gestational age by four cms. The association for risk factors between the various socio-demographic parameters and SGA was analysed using chi-square test for categorical data and t-Test for continuous data with p value<0.05 considered as significant. The mothers and babies were followed up till discharge from the hospital for outcomes. Result: There was a total of 140 SGA with 10 appropriate for gestational age (AGA) fetuses among 6,500 hospital deliveries above 28 weeks' gestation, hence the prevalence was 2.15%. The risk factors for very small for gestational age were history of birth of SGA fetus (OR, 1.25; 95% CI, 1.15-1.35); history of recurrent pregnancy loss (OR, 1.25; 95% CI, 1.15-1.35); personal history of substances abuse in the index pregnancy (OR, 1.68; 95% CI, 1.47-1.92); adverse obstetrics or medical events in the index pregnancy (OR, 2.21; 95% CI, 1.10-4.45); high blood pressure at admission (OR, 1.58; 95% CI, 1.96- 2.59) and significant urinary proteinuria (OR, 2.26; 95% CI, 1.00-5.09).SGA newborns correlated with increased risk of operative delivery and adverse perinatal outcomes, including oligohydramnios, low Apgar scores, resuscitation at birth, admission to the neonatal intensive care unit or nursery, metabolic complications and fetal death. Conclusions: SGA have distinct modifiable risk factors and mortality patterns suggesting potential implications for public health and urgent need to intervene with effective interventions.

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Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

Journal of Clinical Medicine ◽

10.3390/jcm10040643 ◽

2021 ◽

Vol 10 (4) ◽

pp. 643

Author(s):

Veronica Giorgione ◽

Corey Briffa ◽

Carolina Di Fabrizio ◽

Rohan Bhate ◽

Asma Khalil

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Chi Square ◽

Increased Risk ◽

Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

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Comparison of neonatal outcomes of small for gestational age and appropriate for gestational age preterm infants born at 28–36 weeks of gestation: a multicentre study in Ethiopia

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000740 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000740

Author(s):

Netsanet Workneh Gidi ◽

Robert L Goldenberg ◽

Assaye K Nigussie ◽

Elizabeth McClure ◽

Amha Mekasha ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Late Onset ◽

Early Recognition ◽

Neonatal Outcomes ◽

P Value ◽

Prolonged Hospitalisation ◽

Increased Risk ◽

Appropriate For Gestational Age

PurposeThe aim of this study was to assess morbidity and mortality pattern of small for gestational age (SGA) preterm infants in comparison to appropriate for gestational age (AGA) preterm infants of similar gestational age.MethodWe compared neonatal outcomes of 1336, 1:1 matched, singleton SGA and AGA preterm infants based on their gestational age using data from the study ‘Causes of Illness and Death of Preterm Infants in Ethiopia (SIP)’. Data were analysed using SPSS V.23. ORs and 95% CIs and χ2 tests were done, p value of <0.05 was considered statistically significant.ResultThe majority of the infants (1194, 89%) were moderate to late preterm (32–36 weeks of gestation), 763 (57%) were females. Male preterm infants had higher risk of being SGA than female infants (p<0.001). SGA infants had increased risk of hypoglycaemic (OR and 95% CI 1.6 (1.2 to 2.0), necrotising enterocolitis (NEC) 2.3 (1.2 to 4.1), polycythaemia 3.0 (1.6 to 5.4), late-onset neonatal sepsis (LOS) 3.6 (1.1 to 10.9)) and prolonged hospitalisation 2.9 (2.0 to 4.2). The rates of respiratory distress syndrome (RDS), apnoea and mortality were similar in the SGA and AGA groups.ConclusionNeonatal complications such as hypoglycaemic, NEC, LOS, polycythaemia and prolonged hospitalisation are more common in SGA infants, while rates of RDS and mortality are similar in SGA and AGA groups. Early recognition of SGA status, high index of suspicion and screening for complications associated and timely intervention to prevent complications need due consideration.

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Pattern of congenital anomalies in neonates at tertiary care centre in Hyderabad, India: a hospital based prospective observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20185103 ◽

2018 ◽

Vol 6 (1) ◽

pp. 63

Author(s):

Paramesh Pandala ◽

Rakesh Kotha ◽

Himabindu Singh ◽

Nirmala C.

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Congenital Anomalies ◽

Prospective Observational Study ◽

Maternal Obesity ◽

Consanguineous Marriage ◽

Age Group ◽

Increased Risk ◽

History Of ◽

Male Sex

Background: With advancements of perinatal, neonatal care congenital defects were the most common cause of morbidity and mortality in developed world. It is one of the common causes of morbidity and mortality in India. Its incidence also influenced by many preventable risk factors. Hence, we are carried out this study to know the changing pattern of congenital anomalies and to know the effect of environmental risk factors on congenital anomalies.Methods: Prospective observational study conducted at Niloufer hospital Hyderabad during period from November 2017 to 2018. We included intramural and extramural babies. Analysed data by appropriate statistical methods.Results: Most common system involved was Central nervous system (CNS) with 25 cases out of 112 cases followed by Gastrointestinal system (GIT)and Cardiovascular system (CVS). Meningomyelocele, anorectal malformations and acyanotic heart diseases were most common type of congenital anomalies. Thirty seven to forty weeks gestational age group babies were most commonly have congenital anomalies than other gestational age group babies. Low birth weight babies had higher percentage of congenital anomalies (2.64%). Congenital anomalies were more in the male sex (2.53%) as compared to female babies (1.73%). Maternal obesity, consanguineous marriage and previous family history of congenital anomalies associated with increased risk of congenital anomalies with significant p values.Conclusions: Incidence of congenital anomalies was 2.15%. Most of congenital anomalies were involved in CNS. Birth weight, Gestational age, Male sex, consanguineous marriage, maternal Obesity and previous family history of congenital anomalies were significantly associated with increased risk of congenital anomalies.

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Is a history of preeclampsia associated with an increased risk of a small for gestational age infant in a future pregnancy?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2016.03.011 ◽

2016 ◽

Vol 215 (3) ◽

pp. 355.e1-355.e6 ◽

Cited By ~ 9

Author(s):

Anna Palatnik ◽

William A. Grobman ◽

Emily S. Miller

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Increased Risk ◽

History Of ◽

Future Pregnancy

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Risk factors and perinatal outcomes associated with idiopathic small for gestational age Taiwanese newborns

International Journal of Gynecology & Obstetrics ◽

10.1016/j.ijgo.2013.03.033 ◽

2013 ◽

Vol 122 (3) ◽

pp. 212-215 ◽

Cited By ~ 6

Author(s):

Tai-Ho Hung ◽

T'sang-T'ang Hsieh ◽

Liang-Ming Lo ◽

Tsung-Hung Chiu ◽

Ching-Chang Hsieh ◽

...

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes

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856A gestational age specific prognostic model for adverse perinatal events in obese women

International Journal of Epidemiology ◽

10.1093/ije/dyab168.088 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Jeffrey Bone ◽

Sarka Lisonkova

Keyword(s):

Risk Factors ◽

British Columbia ◽

Gestational Age ◽

Proportional Hazards Model ◽

Perinatal Outcomes ◽

Cox Proportional Hazards Model ◽

Prognostic Models ◽

Chronic Hypertension ◽

Obese Women ◽

Increased Risk

Abstract Background Obesity is one of the most preventable pre-pregnancy risk factors for adverse perinatal events. Despite this, there are few body-mass-index (BMI) specific prognostic models for timing of delivery associated with the lowest number of adverse perinatal events. Our aim was to build a predictive model to quantify gestational age-specific rates of adverse birth outcomes in obese women with and without additional risk factors. Methods All singleton births at ≥ 34 weeks’ gestation in British Columbia, Canada, 2008-2017 (n = 283,697) were included and data were obtained from the British Columbia Perinatal Database Registry. A multivariable Cox proportional hazards model including demographic and obstetric risk factors was used to estimate gestational age specific risk of composite perinatal mortality and severe morbidity. Results Among all women, 13.1% were obese (pre-pregnancy BMI ≥30m/kg2), 60.1% had normal BMI (18.5-24.9 m/kg2). In high-risk obese women (nulliparous with chronic hypertension, and diabetes), adjusted outcome rates (per 1000 ongoing pregnancies) were 7.5 at 34-36 weeks, 20.4 at 37-39 weeks, and 83.5 at ≥ 40 weeks’ gestation. In all obese women, the rates were 1.93, 6.27, and 18.5 per 1000 ongoing pregnancies, respectively. In contrast, on average these rates were 1.14, 4.03 and 11.6 per 1000 ongoing pregnancies, respectively, among women with normal BMI. Conclusions Obese women are at increased risk of poor perinatal outcomes at all gestational ages. These risks are compounded by other conditions known to effect perinatal outcomes. Key messages Obese women require specific guidelines for timing of optimal delivery.

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PREVALENCE AND RISK FACTORS OF DIABETES MELLITUS IN TUBERCULOSIS PATIENT AT PATRANG DISTRICT INDONESIA

Indonesian Journal of Tropical and Infectious Disease ◽

10.20473/ijtid.v7i4.7534 ◽

2019 ◽

Vol 7 (4) ◽

pp. 79

Author(s):

Hasri Yulia Sasmita ◽

Irma Prasetyowati ◽

Pudjo Wahjudi

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Central Obesity ◽

Smoking Status ◽

Sampling Technique ◽

Tuberculosis Patient ◽

P Value ◽

Cross Sectional ◽

History Of

Tuberculosis (TB) is one of cause of death in infectious disease domain. The control of TB is complicated because the inclination of case numbers people with Diabetes Mellitus. Diabetes Mellitus (DM) is an important risk factor for TB development, with prove that more than ten percent of TB patient is DM patient. People with DM have risk three times more likely to suffer from TB than people without DM. The results of TB treatment with comorbid DM will be easier to be failed. Puskesmas Patrang have the highest bacteriologically confirmed BTA TB cases and DM cases in Jember during 2014 until 2016. The aim of this research is to know the DM prevalence in TB patients and to analyze the correlation between DM risk factors in TB patient to TB-DM incidence at Puskesmas Patrang Jember in 2017. The research uses observasional analytic with cross sectional approach. The sampling technique uses simple random sampling with 47 samples. The independent variables include respondent characteristics (age, sex, type of TB, medication category, and family history of DM), central obesity and smoking behavior. While the dependent variable is the DM status. The result shows that the prevelance of DM in TB patients at Puskesmas Patrang Jember regency is 23,4%. Factors associated with TB-DM are age (p-value = 0,012), family history of DM (p-value = 0,003), and smoking status (p-value = 0,035). Factors that do not associated with TB-DM are sex (p-value = 0,731), type of TB (p-value = 0,170), treatment category of TB (p-value = 0,560), central obesity (p-value = 0,435), the number of cigarette (p-value = 1,000) and smoking duration (p-value = 1,000). The most important factor of TB-DM is family history of DM that 10,850 times higher of getting TB-DM than patients without family history of DM.

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Abstract P169: Association Between Years Of Residency In The Usa Of Hispanic Immigrant Women And Small For Gestational Age

Circulation ◽

10.1161/circ.143.suppl_1.p169 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Ileana De Anda-Duran

Keyword(s):

Gestational Diabetes ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

Perinatal Period ◽

P Value ◽

Negative Effects ◽

Alternative Pathways ◽

The Us ◽

The Usa

Maternal and fetal factors have been associated with small for gestational age (SGA) and cardiometabolic disease in adulthood. Acculturation in US Latino population has been correlated with negative effects on health, including during perinatal period. We hypothesized that acculturated Hispanic pregnant women have higher risk of SGA. Methods: Retrospective study from PeriBank participants born in Latin America. Length of stay (LOS) as proxy for acculturation. SGA defined as birth weight for gestational age <10 th . Results: We included 13,613 women with 15,376 deliveries. Women with LOS >6y showed higher gestational diabetes rates. (Table1) After adjustment, risk of SGA was lower for LOS 4-6y vs. 0-3y; risk was also lower for LOS >6y vs. 0-3y. (Table2) Women with LOS 4-6y had a 1.12kg/m 2 [95% CI 0.84 - 1.39; p-value <0.001] and >6y 3.06kg/m 2 [95% CI 2.78 - 3.32; p<0.001] higher BMI compared to LOS of 0-3 after adjustment. Conclusions: Highly acculturated Hispanic women born outside the US, do not have higher risk for having SGA offspring. Likely masked by higher pre-pregnancy BMI and gestational diabetes, alternative pathways for adverse perinatal outcomes.

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