Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study
Objective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Regi...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Journal of Pregnancy |
| Online Access: | http://dx.doi.org/10.1155/2011/293516 |
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| author | K. E. Boers J. A. M. van der Post Ben W. J. Mol J. M. M. van Lith S. A. Scherjon |
| author_facet | K. E. Boers J. A. M. van der Post Ben W. J. Mol J. M. M. van Lith S. A. Scherjon |
| author_sort | K. E. Boers |
| collection | DOAJ |
| description | Objective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Registry (PRN).
Methods. We used data of all nulliparae between 2000 and 2005 with a singleton in cephalic presentation beyond 36+0 weeks, with a birth weight below the 10th percentile. We analysed two groups of pregnancies: (I) with isolated SGA and (II) with both SGA and hypertensive disorders. Onset of labour was related to route of delivery and neonatal outcome.
Results. Induction was associated with a higher risk of emergency caesarean section (CS), without improvement in neonatal outcome. For women with isolated SGA the relative risk of emergency CS after induction was 2.3 (95% Confidence Interval [CI] 2.1 to 2.5) and for women with both SGA and hypertensive disorders the relative risk was 2.7 (95% CI 2.3 to 3.1).
Conclusion. Induction in pregnancies complicated by SGA at term is associated with a higher risk of instrumental deliveries without improvement of neonatal outcome. Prospective studies are needed to determine the best strategy in suspected IUGR at term. |
| format | Article |
| id | doaj-art-ca838e48ca714278a4d35ef4784dc9c3 |
| institution | Kabale University |
| issn | 2090-2727 2090-2735 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Pregnancy |
| spelling | doaj-art-ca838e48ca714278a4d35ef4784dc9c32025-02-03T05:59:18ZengWileyJournal of Pregnancy2090-27272090-27352011-01-01201110.1155/2011/293516293516Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort StudyK. E. Boers0J. A. M. van der Post1Ben W. J. Mol2J. M. M. van Lith3S. A. Scherjon4Department of Gynaecology and Obstetrics, Bronovo Hospital, Bronovolaan 5, 2597 AX The Hague, The NetherlandsDepartment of Obstetrics, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Obstetrics, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Obstetrics, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The NetherlandsDepartment of Obstetrics, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The NetherlandsObjective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Registry (PRN). Methods. We used data of all nulliparae between 2000 and 2005 with a singleton in cephalic presentation beyond 36+0 weeks, with a birth weight below the 10th percentile. We analysed two groups of pregnancies: (I) with isolated SGA and (II) with both SGA and hypertensive disorders. Onset of labour was related to route of delivery and neonatal outcome. Results. Induction was associated with a higher risk of emergency caesarean section (CS), without improvement in neonatal outcome. For women with isolated SGA the relative risk of emergency CS after induction was 2.3 (95% Confidence Interval [CI] 2.1 to 2.5) and for women with both SGA and hypertensive disorders the relative risk was 2.7 (95% CI 2.3 to 3.1). Conclusion. Induction in pregnancies complicated by SGA at term is associated with a higher risk of instrumental deliveries without improvement of neonatal outcome. Prospective studies are needed to determine the best strategy in suspected IUGR at term.http://dx.doi.org/10.1155/2011/293516 |
| spellingShingle | K. E. Boers J. A. M. van der Post Ben W. J. Mol J. M. M. van Lith S. A. Scherjon Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study Journal of Pregnancy |
| title | Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study |
| title_full | Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study |
| title_fullStr | Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study |
| title_full_unstemmed | Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study |
| title_short | Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study |
| title_sort | labour and neonatal outcome in small for gestational age babies delivered beyond 36 0 weeks a retrospective cohort study |
| url | http://dx.doi.org/10.1155/2011/293516 |
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