Perinatal correlates and neonatal outcomes of small for gestational age infants born at term gestation
Perinatal correlates and neonatal outcomes of small for gestational age infants born at term gestation
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DOI：
10.1067/mob.2001.116749
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发表时间：
2001-09-01
影响因子：
9.8
通讯作者：
Hack, M
中科院分区：
文献类型：
--
作者：
Doctor, BA;O'Riordan, MA;Hack, M
目的：我们试图研究目前围产期的相关因素和新生儿发病率与胎儿宫内生长障碍的新生儿在足月妊娠出生。我们比较了372例小于胎龄儿（SGA，出生体重<第10百分位数）足月妊娠出生的婴儿至372例适合胎龄对照的婴儿（阿加，出生体重第10至第90百分位数）匹配的性别，种族和胎龄在2周内。与阿加对照相比，（P <0.05）SGA状态的母亲危险因素包括单身婚姻状况（59%对53%），孕前体重较低（144 +/-41磅对153 +/-40磅），怀孕期间体重增加较少（29 +/-15磅对33 +/-15磅），吸烟（25%对17%），高血压（14%对7%）和多胎妊娠（9%对2%）。SGA婴儿的母亲更有可能接受多次（大于或等于3次）产前超声评估（19%对7%）、生物物理轮廓监测（11%对4%）和催产素分娩诱导（28%对16%）（P <0.05）。儿科医生的参与在SGA分娩中更为常见（50%对37%，P <0.05）。SGA婴儿的体温过低（18%对6%）和症状性低血糖（5%对1%）发生率显著较高。这些新生儿的问题仍然显着，即使当医学或病理原因的宫内生长障碍，包括妊娠高血压，多胎妊娠，先天畸形，excluded.CONCLUSION：尽管较高的妊娠并发症的母亲SGA婴儿，新生儿不良结局的发生率低。然而，SGA婴儿仍然有低体温和低血糖的风险，需要仔细的新生儿监护。
OBJECTIVE: We sought to examine the current perinatal correlates and neonatal morbidity associated with intrauterine growth failure among neonates born at term gestation.STUDY DESIGN. We compared 372 small for gestational age (SGA, birth weight < 10th percentile) infants born at term gestation to 372 appropriate for gestational age controls (AGA, birth weight 10th to 90th percentile) matched by sex, race, and gestational age within 2 weeks.RESULTS: Compared with AGA controls, significant (P < .05) maternal risk factors for SGA status included single marital status (59% versus 53%), lower prepregnancy weight (144 +/- 41 lbs versus 153 +/- 40 lbs), lower weight gain during pregnancy (29 +/- 15 lbs versus 33 +/- 15 lbs), smoking (25% versus 17%), hypertension (14% versus 7%), and multiple gestation (9% versus 2%). Mothers of SGA infants were more likely to undergo multiple ( greater than or equal to3) antenatal ultrasound evaluations (19% versus 7%), biophysical profile monitoring (11 % versus 4%), and oxytocin delivery induction (28% versus 16%) (P < .05). Pediatrician attendance was more common among SGA deliveries (50% versus 37%, P < .05). SGA infants had significantly higher rates of hypothermia (18% versus 6%) and symptomatic hypoglycemia (5% versus 1 %). These neonatal problems remained significant even when medical or pathologic causes of intrauterine growth failure, including pregnancy hypertension, multiple gestation, and congenital malformations, were excluded.CONCLUSION: Despite higher rates of pregnancy complications among mothers of SGA infants, the rates of neonatal adverse outcomes are low. However, SGA infants remain at risk for hypothermia and hypoglycemia and require careful neonatal surveillance.