Meeting paperSMFM paperThe risk of intrauterine fetal death in the small-for-gestational-age fetus
Section snippets
Materials and Methods
To examine the risk of IUFD at a given week of gestation based on fetal growth, we conducted a retrospective cohort study of all singleton neonates born to women in the United States in 2005. The period-linked live birth and fetal death files from the National Center for Health Statistics (NCHS) (Centers for Disease Control and Prevention) for the year 2005 were exported and aggregated to form a single database comprising all fetal deaths and births from Jan. 1 through Dec. 31, 2005. Data were
Results
The NCHS database included 3,399,816 nonanomalous singletons delivered between 24 0/7-41 6/7 weeks' gestation. Of these, 96,825 were <3rd percentile, 157,922 were <5th percentile, 322,161 were <10th percentile, and 3,077,655 were ≥10th percentile. Maternal age, parity, race, smoking history, and educational status differed in the birthweight groups (Table 1).
The risk of IUFD is greater for lower percentile thresholds of SGA pregnancies at all weeks of gestation (Table 2). The 3rd-percentile
Comment
These findings substantiate previous studies regarding the risk of IUFD in SGA and non-SGA pregnancies, and then further delineate this risk by week of gestation and in 3 percentile ranges within the <10th-percentile group.2, 3, 4, 5, 6, 7, 8 In all cohorts of SGA pregnancies the risk for fetal death was greater at all gestational ages than for non-SGA pregnancies. In the late preterm period, the risk rose for all pregnancies with the greatest risk faced by the smallest fetuses in late term and
References (23)
- et al.
A practical classification of newborn infants by weight and gestational age
J Pediatr
(1967) - et al.
Neonatal mortality rate: relationship to birth weight and gestational age
J Pediatr
(1972) - et al.
Impaired growth and risk of fetal death: is the tenth percentile the appropriate standard?
Am J Obstet Gynecol
(1998) - et al.
Umbilical and uteroplacental blood flow velocity waveforms in pregnancies with fetal growth retardation
Eur J Obstet Gynecol Reprod Biol
(1988) - et al.
Doppler assessment of the fetoplacental circulation in normal and growth-retarded fetuses
Eur J Obstet Gynecol Reprod Biol
(1984) - et al.
Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination
Am J Obstet Gynecol
(2002) - et al.
Intrauterine growth as estimated from live born birth-weight data at 24 to 42 weeks of gestation
Pediatrics
(1963) - et al.
Neonatal mortality risk in relation to birth weight and gestational age: an update
J Pediatr
(1982) - et al.
Birthweight in relation to morbidity and mortality among newborn infants
N Engl J Med
(1999) - et al.
A population study of the relationship between fetal death and altered fetal growth
Obstet Gynecol
(1989)
Population study of the risk of fetal death and its relationship to birthweight, gestational age, and race
Am J Perinatol
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Y.W.C. is supported by the National Institute of Child Health and Human Development, grant number HD01262, as a Women's Reproductive Health Research Scholar.
The authors report no conflict of interest.
Cite this article as: Pilliod RA, Cheng YW, Snowden JM, et al. The risk of intrauterine fetal death in the small-for-gestational-age fetus. Am J Obstet Gynecol 2012;207:318.e1-6.