Distribución espacial y tendencia secular (1991-2014) de nacidos pequeños para la edad gestacional en Jujuy / Spatial distribution and secular trend (1991­2014) of small for gestational age infants born in Jujuy

Introducción. El feto que no alcanza el potencial de crecimiento esperado en el útero se considera pequeño para la edad gestacional (PEG). Esta restricción depende de factores genéticos y/o ambientales; la altura geográfica es uno muy relevante. Este trabajo analiza la distribución espacial de las prevalencias de PEG y su tendencia secular en Jujuy (1991-2014). Materiales y métodos. Se analizaron los registros de 308 469 nacidos vivos de Jujuy (Dirección de Estadísticas e Información de Salud). Se estimaron prevalencias de PEG (peso/edad gestacional

Introduction. A fetus that does not reach the expected growth potential in utero is considered small for gestational age (SGA). Such restriction depends on genetic and/or environmental factors, being altitude a very relevant factor. This study analyzes the spatial distribution of the prevalence of SGA and its secular trend in Jujuy (1991­2014). Materials and methods. The records of 308 469 live births in Jujuy (Health Statistics and Information Department) were analyzed. The prevalence of SGA (weight/gestational age < P10 and < P3) was estimated for sex according to the INTERGROWTH-21 st standard in the ecoregions of Jujuy (Valle and Ramal ­less than 2000 MASL­, Puna, and Quebrada) across 3 periods (1991­2000, 2001­2009, 2010­2014) and proportions were compared. The secular trend was assessed using the Joinpoint regression analysis. Results. The overall prevalence of SGA was 2.3% (< P3) and 7% (< P10). Significantly higher values were observed in Puna and Quebrada in both SGA categories and across all periods. Only in Valle, significant differences were observed between sexes across all periods. The prevalence of SGA showed a significant downward secular trend at a provincial and regional level, and this was greater in Quebrada (5.2% < P3 and 3.5% < P10). Conclusions. A consistent and significant decrease in the prevalence of SGA has been observed since the 1990s in Jujuy, where altitude is itself a determining factor of size at birth, since the Puna and Quebrada regions showed the highest prevalence of SGA during the entire period.

Recent research on the influence of intrauterine growth restriction on the structure and function of the nervous system / 中国当代儿科杂志

Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system.

Analysis of maternal clinical risk factors for different degrees of small for gestational age infant / 上海交通大学学报（医学版）

Objective : To explore the pregestational and gestational risk factors associated with small for gestational age infant (SGA) by dif-ferent degrees. Methods ¡¤ Mothers and single newborns delivered at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to December 2016 were included. Multivariate Logistic regression was used to analyze the correlation between maternal preg-nancy and pre-pregnancy risk factors and the occurrence of SGA by different degrees. Results ¡¤ There were no statistically significant differ-ences in maternal age, number of birth, education level, incidence of preterm birth and fetal sex in SGA. Maternal body mass index (BMI), gesta-tional hypertension and accepting assisted reproduction were significantly correlated with SGA (all P<0.05). The incidence of moderate SGA in mothers with low pre-pregnancy BMI and gestational hypertension were 3.6 and 4.0 times higher than that of the mothers with normal BMI and blood pressure. The incidence of severe SGA in mothers receiving assisted reproduction was 6.4 times higher than that in those who did not. Mild SGA was not associated with the above risk factors. Conclusion ¡¤ Maternal low BMI and hypertension are the risk factors of moderate SGA and accepting assisted reproduction are the risk factors of severe SGA, and the risk factors of SGA by different degrees are not the same.

Korean reference for full-term birth length by sex: data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES-IV; 2007–2009)

PURPOSE: The purpose of this study was to construct reference data for birth length of full-term and preterm Korean infants by sex and to define a sex-specific birth length cut-off to identify small for gestational age (SGA).METHODS: Data were collected from the 4th Korean National Health and Nutrition Examination Survey (2007–2009), comprising 843 children with birth length data and birth history.RESULTS: References for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles of birth length and weight were created using singleton neonates of gestational age (GA) 36–37 weeks and 38–41 weeks by sex. The birth length cutoff value for SGA (<10th percentile) was 48 cm in both male and female neonates, and the ≤3rd percentile cutoff was 47 cm in males and 46 cm in females born at a GA of 38–41 weeks.CONCLUSION: New Korean reference data were created for birth length and differed from those of other ethnicities. Further research on short-term and long-term health outcomes of SGA infants based on the new reference data is needed.

Pregnancy-related anxiety associated with small-for-gestational-age infants / 中华流行病学杂志

Objective To investigate the second or third trimester pregnancy-related anxiety on small-for-gestational-age infants.Methods This study was based on Ma'anshan Birth Cohort Study (MABC),with 3 040 maternal-singleton pairs finally selected for data analysis,from May 2013to September 2014.The psychological state of pregnancy was evaluated according to a self-developed ‘ anxiety scale for gestation'.Small-for-gestational-age was defined as ‘ having birth weight below the 10th percentile at a particular gestational week',while large-for-gestational-age infants was defined as ‘having birth weight above the 90th percentile'.Birth weight between the 10th and 90th percentile was classified as appropriate-for-gestational age infants.x2 test was used to compare the distribution of characteristics in pregnancy among three groups with different birth weights.Multivariate logistic regression models were conducted to evaluate the associations between third trimester pregnancy-related anxiety and birth weight.Results The incidence rates of small-and large-gestational-age infants were 9.6％ and 16.6％,respectively.Difference between women with only one of the second or third trimester pregnancy-related anxiety syndromes and small-for-gestational-age infants showed no statistical significance.Women with both second and third trimester pregnancy-related anxieties might increase the risk of small-for-gestational-age infants (OR=1.39,95％CI:1.04-1.87).However,there was no significant difference between pregnancy-related anxiety and large-for-gestational-age infants (OR=1.05,95％ CI:0.81-1.35) noticed.Conclusion Women with second and third trimesterpregnancy-related anxiety appeared a risk factor for small-for-gestational-age infants.

A matched case-control study on perinatal risk factors of early onset thrombocytopenia in full-term small for gestational age infants / 临床儿科杂志

Objective To explore the perinatal risk factors of early onset thrombocytopenia (EOT) in full-term small for gestational age infants. Methods A 1:1 or 1:2 matched case control study was carried out. A total of 93 full-term small for gestational age infants with EOT were selected from April 2008 to July 2014 as the case group, and the non EOT full-term small for gestational age infants with the birth weight difference <250 g and the gestational age difference <3 days were selected as the control group. The clinical data during perinatal period and laboratory examination results after admission were collected retrospectively. And the differences between the two groups were compared. Results The incidence of intrauterine distress (41.9％ vs. 25.8％, χ2=7.35, P=0.007), amniotic fluid contamination (39.8％ vs. 27％, χ2=4.66, P=0.031), and early-onset sepsis (39.8％ vs. 27％, χ2=4.66, P=0.031) were significantly higher in the case group than those in the control group. Conditional logistics regression analysis showed that intrauterine distress (β=0.60, OR=1.82, 95％CI=1.04～3.17, P=0.035) and early-onset sepsis (β=1.69, OR=5.44, 95％CI=1.11～26.76, P=0.037) were related to EOT. Conclusions Intrauterine distress and early-onset sepsis are risk factors for the onset of EOT in full-term small for gestational age infants.

Pregnancy-related anxiety associated with small-for-gestational-age infants / 中华流行病学杂志

Objective To investigate the second or third trimester pregnancy-related anxiety on small-for-gestational-age infants.Methods This study was based on Ma'anshan Birth Cohort Study (MABC),with 3 040 maternal-singleton pairs finally selected for data analysis,from May 2013to September 2014.The psychological state of pregnancy was evaluated according to a self-developed ‘ anxiety scale for gestation'.Small-for-gestational-age was defined as ‘ having birth weight below the 10th percentile at a particular gestational week',while large-for-gestational-age infants was defined as ‘having birth weight above the 90th percentile'.Birth weight between the 10th and 90th percentile was classified as appropriate-for-gestational age infants.x2 test was used to compare the distribution of characteristics in pregnancy among three groups with different birth weights.Multivariate logistic regression models were conducted to evaluate the associations between third trimester pregnancy-related anxiety and birth weight.Results The incidence rates of small-and large-gestational-age infants were 9.6％ and 16.6％,respectively.Difference between women with only one of the second or third trimester pregnancy-related anxiety syndromes and small-for-gestational-age infants showed no statistical significance.Women with both second and third trimester pregnancy-related anxieties might increase the risk of small-for-gestational-age infants (OR=1.39,95％CI:1.04-1.87).However,there was no significant difference between pregnancy-related anxiety and large-for-gestational-age infants (OR=1.05,95％ CI:0.81-1.35) noticed.Conclusion Women with second and third trimesterpregnancy-related anxiety appeared a risk factor for small-for-gestational-age infants.

Relationship between Neonatal Umbilical Cord Blood Irisin Level and Birth Weight and Intrauterine Growth Restriction / 医学研究杂志

Objective SGA and IURG fetuses are important risk factors for metabolic disease in adulthood,but the mechanism is not clear.In this study,Irisin levels in umbilical cord blood of different birth weight and IURG neonates were measured and the relationship between Irisin and neonatal weight,gestational age and other factors was explored.Methods This study was conducted in the cross-sectional study of neonates born in our hospital from 2014 to 2016.Newborns were divided into small-for-gestational age (SGA),greater-than-gestational age (LGA),gestational age (AGA) and newborns with intrauterine growth restriction (IUGR).The levels of irisin in umbilical cord blood of 4 newborns were detected.Results In this study,there were a total of 110 cases of newborns.The mean gestational age and mean birth weight of newborns in the SGA group was lower than that in the other three groups(P =0.000).The mean Irisin levels in the SGA and IUGR groups [54.4(45.6-66.7) ng/ml,53.7 (40.3-62.4) ng/ml] were significantly lower than those in the AGA group [67.7 (53.8-78.1) ng/ml,64.7 (53.6-71.2) ng/ml] (P =0.000).The mean insulin levels in the LGA group [7.54(0.83-58.96)mIU/ml] were significantly higher than those in the AGA group [38.00(34.40-39.30)mIU/ml] and IU-GR [3.86(0.49-16.15)] and SGA [4.19 (0.62-14.42)mIU/ml] (P =0.000).In the present study,the correlation analysis showed that Irisin level in neonatal umbilical cord blood was significantly correlated with neonatal gestational age (r =0.22,P ＜ 0.01),fetal weight (r =0.17,P ＜0.01) and maternal age (r =-0.12,P =0.021).However,only in the LGA group,the level of Irisin in cord blood of neonates was positively correlated with insulin level (r =0.41,P =0.042).Multivariate linear regression analysis revealed that SGA (β =-0.14,P =0.02) and fetal weight (β =0.05,P =0.008) were independent risk factors for neonatal umbilical cord blood Irisin levels.Conclusion There was a positive correlation between irisin level and neonatal umbilical cord blood birth weight.The levels of irisin in the neonates of the SGA and IURG groups were significantly lower than those of the AGA and LGA groups,but irisin levels did not differ between the SGA and IURG groups and between AGA and LGA groups.And irisin levels in the LGA group were positively correlated with insulin levels.Our results also reveal that singleton infants of mothers with preeclampsia had lower cord blood irisin levels compared to infants of mothers without preeclampsia.

Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

OBJECTIVE: To examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants. METHODS: This prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies. The women's maternal history was recorded, and the PlGF and PAPP-A levels at 11 to 13 gestational weeks were measured. During the second trimester, the maternal uterine artery's systolic/diastolic ratio was measured. Multiples of the median (MoM) of PlGF and PAPP-A were determined, and the associations of these values with the risk factors of SGA and PE were evaluated. Logistic regression analysis was used to determine whether PlGF and PAPP-A are useful markers for predicting SGA infants. RESULTS: The PAPP-A MoM level was significantly lower in women with advanced maternal age, multipara women, and women with gestational diabetes than in their counterparts. The PlGF and PAPP-A MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. There was a significant relationship between the maternal serum PAPP-A MoM level in the first trimester and the uterine artery systolic/diastolic ratio in the second trimester. Results of logistic regression analysis showed that low PlGF and PAPP-A MoM levels were predictors of SGA infants (odds ratio, 0.143; 95% confidence interval, 0.025 to 0.806; odds ratio, 0.191; 95% confidence interval, 0.051 to 0.718, respectively). CONCLUSION: PlGF and PAPP-A are potentially useful as first-trimester markers for SGA infants and some hypertensive disorders of pregnancy.

Postdischarge growth assessment in very low birth weight infants / 소아과

PURPOSE: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. METHODS: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. RESULTS: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). CONCLUSION: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

Catch-up growth and catch-up fat in children born small for gestational age / 소아과

Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.

NBNA used to assess the neurodevelopment of full-term small for gestational age infants / 国际儿科学杂志

Objective To investigate the difference of nerve behavior among the different types of fullterm small for gestational age infants(SGA) infants and the reasons.Methods The neonatal behavioral neurological assessment(NBNA) scores were given for 148 full-term SGA infants aged 7,14 and 28 days born in Affiliated Hospital of Hebei University.The comparason analysis was conducted among three types including symmetic,asymmetric and the mixture of them.Results Significant differences (P ＜ 0.05) were found between the NBNA scores for full-term SGA infants and normal infants.The NABA scores of full-term SGA infants were lower than those of normal infants.The NBNA scores for three types of full-term SGA infants followed the order of asymmetric ＞ symmetric ＞ mixture of them,significant difference was found between any two types of three types(P ＜ 0.05).Conclusion Full-term SGA infants show the poorer quality of nerve behavior compared with the nomal infants.The neurodevelopment levels for three types of full-term SGA infants are asymmetric,symmetric,mixture of them in the order.

A developmental perspective on the origins of obesity and metabolic syndrome

Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, glucose intolerance, and insulin resistance. Children sometimes develop metabolic syndrome, and it is strongly associated with the same syndrome in adulthood. Recently, there is evidence that obesity and metabolic syndrome originate from fetal life. Possible explanations of fetal and developmental origin of metabolic syndrome are the thrifty genotype and thrifty phenotype hypothesis, which together confer insulin resistance on developing fetus. Poor nutrition in utero as well as extrauterine growth restriction of preterm infants are important triggers of this hypothesis. Like metabolic syndrome in adulthood, the high levels of inflammatory cytokines and adipokines are certainly characteristic in pediatric patients. Increased fat mass was also observed in these patients, although their birth weight was lower than average. The mitochondrial genome is responsible for the inheritance of obesity from the maternal line. This can be a key as to why the phenotypes of obesity and metabolic syndrome start in fetal life with an association with poor maternal nutrition. In such circumstances, catch-up growth with an over-nutrition strategy can aggravate those features, suggesting that rapid catch-up growth in early infancy should not be encouraged.

Efficacy and safety of growth hormone treatment for children born small for gestational age / 소아과

Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of 35-70 microg/kg/day should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

New Korean reference for birth weight by gestational age and sex: data from the Korean Statistical Information Service (2008-2012)

PURPOSE: To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. METHODS: Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. RESULTS: Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. CONCLUSION: The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.

Age at menarche and adult height in girls born small for gestational age

PURPOSE: The aim of this study was to evaluate the association between birth characteristics based on birth weight for gestational age, timing of menarche and adult height in girls born small for gestational age (SGA). METHODS: Thirty subjects born from 1988 through 1999 whose birth weight below 10th percentile for their gestational ages were recruited based on hospital chart reviews. The age of each subject at menarche was recorded, and the subject's heights and bone age were assessed. RESULTS: The adult height of the girls born SGA was significantly lower than the normal adult height and slightly shorter than their target height. The adult height was associated with the birth weight for gestational age. The age at menarche was not different with the menarche timing of the general population. CONCLUSION: More attention may need to be paid to the growth outcomes of SGA patients whose birth weight is lower for their gestational age than other SGA subjects.

Age at menarche and adult height in girls born small for gestational age

PURPOSE: The aim of this study was to evaluate the association between birth characteristics based on birth weight for gestational age, timing of menarche and adult height in girls born small for gestational age (SGA). METHODS: Thirty subjects born from 1988 through 1999 whose birth weight below 10th percentile for their gestational ages were recruited based on hospital chart reviews. The age of each subject at menarche was recorded, and the subject's heights and bone age were assessed. RESULTS: The adult height of the girls born SGA was significantly lower than the normal adult height and slightly shorter than their target height. The adult height was associated with the birth weight for gestational age. The age at menarche was not different with the menarche timing of the general population. CONCLUSION: More attention may need to be paid to the growth outcomes of SGA patients whose birth weight is lower for their gestational age than other SGA subjects.

Perinatal risk factors associated with neurobehavioral development of full-term small for gestational age newborn infants / 中国小儿急救医学

Objective To explore perinatal risk factors associated with the neurobehavioral development of small for gestational age (SGA) full-term neonates.Methods This prospective cross-sectional study included 111 full-term newborn infants from Apr 2008 to Apr 2010 born in Yan-tai Yuhuangding Hospital.Detailed clinical data in perinatal period of all subjects were recorded.Infants aged 3 ～ 7 days were assessed with neonatal behavioral neurological assessment (NBNA) for neurobehavioral development.Logistic regression analysis was used to explore risk factors associated with the score of NBNA.Results Significant differences (P ＜ 0.05) were found between full-term SGA (10.72 ± 1.41,7.13 ± 0.96,7.32 ± 0.74,37.16 ±1.32) and normal neonates (11.27 ± 1.04,7.89 ± 0.72,7.62 ± 0.64,39.12 ± 0.76) in terms of capacity,active and passive muscle tension and NBNA score.Full-term SGA neonates had lower score than control.Univariate logistic regression showed that delivery,placenta abnormalities,umbilical cord abnormalities,infection in perinatal period,gestational hypertension,twin pregnancy,hyperbilirubinemia affected neurobehavioral development of full-term SGA infants.Multivariate logistic regression showed that mothers' infection in perinatal period (OR =2.175,95 ％ CI 1.981 ～ 2.408,P ＜ 0.05),twin pregnancy (OR =1.936,95％ CI 1.517 ～2.368,P ＜ 0.05) and hyperbilirubinemia (OR =1.518,95％ CI 1.072-2.149,P ＜ 0.05) were risk factors for neurobehavioral delay of full-term SGA infants.Conclusion Full-term SGA neonates showed poorer quality in neurobehavior.Risk factors associated with neurobehavior of full-term SGA infants included mothers' infection in perinatal period,twin pregnancy and hyperbilirubinemia.

Umbilical Artery Doppler Study as a Predictive Marker of Perinatal Outcome in Preterm Small for Gestational Age Infants

PURPOSE: To evaluate the merit of umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age (SGA) infants. MATERIALS AND METHODS: A total of 218 patients at 27 - 36 weeks of gestational age (GA) who received antenatal umbilical artery Doppler velocimetry and delivered singleton infants with SGA. The ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery was measured in each patient. The patients were divided into 3 groups: the normal group with S/D ratios of less than 95th percentile (n = 134), elevated S/D ratio group of 95th or more percentile (n = 41), and those with absent/reversed end diastolic flow (n = 43). Maternal characteristics and neonatal outcomes of these groups were comparatively analyzed. RESULTS: The gestational age (GA) at the time of diagnosis of SGA, the mean GA at delivery, and the mean birth weight showed statistically significant difference among three groups (p < 0.001). Also, poor perinatal outcome was significantly increased in infants with abnormal S/D ratio (13.4% vs. 31.7% vs. 67.4%, p < 0.001). Multivariate logistic regression analysis revealed umbilical artery Doppler study as a significant independent factor for prediction of poor perinatal outcome (odds ratio: 3.7, 95% confidence interval 1.4 - 9.5, p = 0.007). CONCLUSION: Antenatal umbilical artery Doppler velocimetry is shown as a significantly efficient marker in predicting perinatal outcome in preterm SGA infants.

Association of pregnancy-induced hypertension with small-for-gestational-age babies / 中华流行病学杂志

Objective To examine the association between pregnancy-induced hypertension(PIH) and small-for-gestational-age babies(SGA)in a Chinese population.Methods Subjects were women who delivered a singleton baby(gestational weeks:equal to or greater than 28,and less than 42)in four cities or counties in Jiangsu and Zhejiang provinces,China,during the period of 1995-2000.A total number of 93 743 women were included.Incidence of SGA was calculated and compared between women with or without PIH and between groups with different severities of PIH.Multiple logistic regression was used to address the relationship between PIH and SGA while controlling for maternal age,occupation,education,parity,BMI,anemia,premature rupture of membranes and fetal sex.The association between PIH and SGA was also examined according to preterm or term delivery.Results The incidence of SGA in women with PIH(6.0%)was higher than women without(4.5%),and the incidence increased with severities of PIH.The adjusted relative risk rates(95%CI)of SGA in women with mild,moderate and severe PIH were 1.17(1.01-1.34),1.69(1.33-2.14),and 3.50(2.57-4.77),respectively,when confounders were controlled for.The risk ratios of SGA in women with PIH among women who delivered a preterm baby wete higher than those among women who delivered a term baby.Conclusion There seemed a statistical association between PIH and SGA,and women with PIH having higher incidence of SGA than those withont PIH.