Meeting paper
SMFM paper
The risk of intrauterine fetal death in the small-for-gestational-age fetus

Presented as a poster at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012.
https://doi.org/10.1016/j.ajog.2012.06.039Get rights and content

Objective

We sought to evaluate the risk of intrauterine fetal death (IUFD) in small-for-gestational-age (SGA) fetuses.

Study Design

We analyzed a retrospective cohort of all births in the United States in 2005, as recorded in a national database. We calculated the risk of IUFD within 3 sets of SGA threshold categories as well as within non-SGA pregnancies using the number of at-risk fetuses as the denominator.

Results

The risk of IUFD increased with gestational age and was inversely proportional to percentile of birthweight for gestational age. The risk for IUFD in those <3rd percentile was as high as 58.0 IUFDs per 10,000 at-risk fetuses, 43.9 for <5th percentile, and 26.3 for <10th percentile compared to 5.1 for non-SGA gestations.

Conclusion

There is an increase in the risk of IUFD in SGA fetuses compared to non-SGA fetuses at all gestational ages with the greatest risk demonstrated in the lowest percentile cohort evaluated.

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

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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.

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