Abstract
Abnormal fetal growth can be associated with factors during pregnancy and at postpartum. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes associated with small-for-gestational age (SGA) and large-for-gestational age (LGA) infants. We performed a population-based retrospective study on 14,641 singleton live births registered in the PEARL-Peristat Study between April 2017 and March 2018 in Qatar. We estimated the incidence and examined the risk factors and outcomes using univariate and multivariate analysis. SGA and LGA incidence rates were 6.0% and 15.6%, respectively. In-hospital mortality among SGA and LGA infants was 2.5% and 0.3%, respectively, while for NICU admission or death in labor room and operation theatre was 28.9% and 14.9% respectively. Preterm babies were more likely to be born SGA (aRR, 2.31; 95% CI, 1.45-3.57) but male infants (aRR, 0.57; 95% CI, 0.4-0.81), those born to parous (aRR 0.66; 95% CI, 0.45-0.93), or overweight (aRR, 0.64; 95% CI, 0.42-0.97) mothers were less likely to be born SGA. On the other hand, males (aRR, 1.82; 95% CI, 1.49-2.19), infants born to parous mothers (aRR 2.16; 95% CI, 1.63-2.82), or to mothers with gestational diabetes mellitus (aRR 1.36; 95% CI, 1.11-1.66), or pre-gestational diabetes mellitus (aRR 2.58; 95% CI, 1.8-3.47) were significantly more likely to be LGA. SGA infants were at high risk of in-hospital mortality (aRR, 226.56; 95% CI, 3.47-318.22), neonatal intensive care unit admission or death in labor room or operation theatre (aRR, 2.14 (1.36-3.22). Monitoring should be coordinated to alleviate the risks of inappropriate fetal growth and the associated adverse consequences.
Highlights
Gestational age and birth weight are two crucial factors for assessing the fetal growth
Monitoring should be coordinated to alleviate the risks of inappropriate fetal growth and the associated adverse consequences
We examined several demographic and medical confounders to assess the risk for small-for-gestational age (SGA) and large-for-gestational age (LGA), while investigating how these confounders are associated with low Apgar score, Neonatal Intensive Care Unit (NICU) admission, and mortality
Summary
Gestational age and birth weight are two crucial factors for assessing the fetal growth. An appropriate birth weight at gestational age (AGA) is critical when assessing the typical development of a newborn infant. There is a substantial disparity in the prevalence of SGA babies (4.6–15.3%) across Europe [4] and LGA babies (5–20%) in developed countries [5]. These varieties are more apparent in developing countries. The variability in the rates of prevalence of SGA and LGA infants is mainly due to socio-environmental factors, population differences, as well as wide variations in the standards applied for assessment in different studies [8, 9].
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