Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies

Suneet P. Chauhan, Madeline Murguia Rice, William A. Grobman, Jennifer Bailit, Uma M. Reddy, Ronald J. Wapner, Michael W. Varner, John M. Thorp, Kenneth J. Leveno, Steve N. Caritis, Mona Prasad, Alan T.N. Tita, George Saade, Yoram Sorokin, Dwight J. Rouse, Jorge E. Tolosa

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To compare morbidity among small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age), appropriate-for-gestational-age (AGA; birth weight 10th to 90th percentile; reference group), and large-for-gestational-age (LGA; birth weight greater than the 90th percentile) neonates in apparently uncomplicated pregnancies at term (37 weeks of gestation or greater). METHODS: This secondary analysis, derived from an observational obstetric cohort of 115,502 deliveries, included women with apparently uncomplicated pregnancies of nonanomalous singletons who had confirmatory ultrasound dating no later than the second trimester and who delivered between 37 0/7 and 42 6/7 weeks of gestation. We used two different composite neonatal morbidity outcomes: hypoxic composite neonatal morbidity for SGA and traumatic composite neonatal morbidity for LGA neonates. Log Poisson relative risks (RRs) with 95% CIs adjusted for potential confounding factors (nulliparity, body mass index, insurance status, and neonatal sex) were calculated. RESULTS: Among the 63,436 women who met our inclusion criteria, SGA occurred in 7.9% (n=4,983) and LGA in 8.3% (n=5,253). Hypoxic composite neonatal morbidity was significantly higher in SGA (1.1%) compared with AGA (0.7%; adjusted RR 1.44, 95% CI 1.07-1.93) but similar between LGA (0.6%) and AGA (adjusted RR 0.84, 95% CI 0.58-1.22). Traumatic composite neonatal morbidity was significantly higher in LGA (1.9%) than AGA (1.0%; adjusted RR 1.88, 95% CI 1.51-2.34) but similar in SGA (1.3%) compared with AGA (adjusted RR 1.28, 95% CI 0.98-1.67). CONCLUSION: Among women with uncomplicated pregnancies, hypoxic composite neonatal morbidity is more common with SGA neonates and traumatic-composite neonatal morbidity is more common with LGA neonates.

Original languageEnglish (US)
Pages (from-to)511-519
Number of pages9
JournalObstetrics and Gynecology
Volume130
Issue number3
DOIs
StatePublished - Sep 1 2017

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Gestational Age
Newborn Infant
Morbidity
Pregnancy
Birth Weight
Insurance Coverage
Second Pregnancy Trimester
Parity
Obstetrics
Body Mass Index

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Chauhan, S. P., Rice, M. M., Grobman, W. A., Bailit, J., Reddy, U. M., Wapner, R. J., ... Tolosa, J. E. (2017). Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies. Obstetrics and Gynecology, 130(3), 511-519. https://doi.org/10.1097/AOG.0000000000002199

Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies. / Chauhan, Suneet P.; Rice, Madeline Murguia; Grobman, William A.; Bailit, Jennifer; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M.; Leveno, Kenneth J.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T.N.; Saade, George; Sorokin, Yoram; Rouse, Dwight J.; Tolosa, Jorge E.

In: Obstetrics and Gynecology, Vol. 130, No. 3, 01.09.2017, p. 511-519.

Research output: Contribution to journalArticle

Chauhan, SP, Rice, MM, Grobman, WA, Bailit, J, Reddy, UM, Wapner, RJ, Varner, MW, Thorp, JM, Leveno, KJ, Caritis, SN, Prasad, M, Tita, ATN, Saade, G, Sorokin, Y, Rouse, DJ & Tolosa, JE 2017, 'Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies', Obstetrics and Gynecology, vol. 130, no. 3, pp. 511-519. https://doi.org/10.1097/AOG.0000000000002199
Chauhan, Suneet P. ; Rice, Madeline Murguia ; Grobman, William A. ; Bailit, Jennifer ; Reddy, Uma M. ; Wapner, Ronald J. ; Varner, Michael W. ; Thorp, John M. ; Leveno, Kenneth J. ; Caritis, Steve N. ; Prasad, Mona ; Tita, Alan T.N. ; Saade, George ; Sorokin, Yoram ; Rouse, Dwight J. ; Tolosa, Jorge E. / Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies. In: Obstetrics and Gynecology. 2017 ; Vol. 130, No. 3. pp. 511-519.
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abstract = "OBJECTIVE: To compare morbidity among small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age), appropriate-for-gestational-age (AGA; birth weight 10th to 90th percentile; reference group), and large-for-gestational-age (LGA; birth weight greater than the 90th percentile) neonates in apparently uncomplicated pregnancies at term (37 weeks of gestation or greater). METHODS: This secondary analysis, derived from an observational obstetric cohort of 115,502 deliveries, included women with apparently uncomplicated pregnancies of nonanomalous singletons who had confirmatory ultrasound dating no later than the second trimester and who delivered between 37 0/7 and 42 6/7 weeks of gestation. We used two different composite neonatal morbidity outcomes: hypoxic composite neonatal morbidity for SGA and traumatic composite neonatal morbidity for LGA neonates. Log Poisson relative risks (RRs) with 95{\%} CIs adjusted for potential confounding factors (nulliparity, body mass index, insurance status, and neonatal sex) were calculated. RESULTS: Among the 63,436 women who met our inclusion criteria, SGA occurred in 7.9{\%} (n=4,983) and LGA in 8.3{\%} (n=5,253). Hypoxic composite neonatal morbidity was significantly higher in SGA (1.1{\%}) compared with AGA (0.7{\%}; adjusted RR 1.44, 95{\%} CI 1.07-1.93) but similar between LGA (0.6{\%}) and AGA (adjusted RR 0.84, 95{\%} CI 0.58-1.22). Traumatic composite neonatal morbidity was significantly higher in LGA (1.9{\%}) than AGA (1.0{\%}; adjusted RR 1.88, 95{\%} CI 1.51-2.34) but similar in SGA (1.3{\%}) compared with AGA (adjusted RR 1.28, 95{\%} CI 0.98-1.67). CONCLUSION: Among women with uncomplicated pregnancies, hypoxic composite neonatal morbidity is more common with SGA neonates and traumatic-composite neonatal morbidity is more common with LGA neonates.",
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T1 - Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies

AU - Chauhan, Suneet P.

AU - Rice, Madeline Murguia

AU - Grobman, William A.

AU - Bailit, Jennifer

AU - Reddy, Uma M.

AU - Wapner, Ronald J.

AU - Varner, Michael W.

AU - Thorp, John M.

AU - Leveno, Kenneth J.

AU - Caritis, Steve N.

AU - Prasad, Mona

AU - Tita, Alan T.N.

AU - Saade, George

AU - Sorokin, Yoram

AU - Rouse, Dwight J.

AU - Tolosa, Jorge E.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - OBJECTIVE: To compare morbidity among small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age), appropriate-for-gestational-age (AGA; birth weight 10th to 90th percentile; reference group), and large-for-gestational-age (LGA; birth weight greater than the 90th percentile) neonates in apparently uncomplicated pregnancies at term (37 weeks of gestation or greater). METHODS: This secondary analysis, derived from an observational obstetric cohort of 115,502 deliveries, included women with apparently uncomplicated pregnancies of nonanomalous singletons who had confirmatory ultrasound dating no later than the second trimester and who delivered between 37 0/7 and 42 6/7 weeks of gestation. We used two different composite neonatal morbidity outcomes: hypoxic composite neonatal morbidity for SGA and traumatic composite neonatal morbidity for LGA neonates. Log Poisson relative risks (RRs) with 95% CIs adjusted for potential confounding factors (nulliparity, body mass index, insurance status, and neonatal sex) were calculated. RESULTS: Among the 63,436 women who met our inclusion criteria, SGA occurred in 7.9% (n=4,983) and LGA in 8.3% (n=5,253). Hypoxic composite neonatal morbidity was significantly higher in SGA (1.1%) compared with AGA (0.7%; adjusted RR 1.44, 95% CI 1.07-1.93) but similar between LGA (0.6%) and AGA (adjusted RR 0.84, 95% CI 0.58-1.22). Traumatic composite neonatal morbidity was significantly higher in LGA (1.9%) than AGA (1.0%; adjusted RR 1.88, 95% CI 1.51-2.34) but similar in SGA (1.3%) compared with AGA (adjusted RR 1.28, 95% CI 0.98-1.67). CONCLUSION: Among women with uncomplicated pregnancies, hypoxic composite neonatal morbidity is more common with SGA neonates and traumatic-composite neonatal morbidity is more common with LGA neonates.

AB - OBJECTIVE: To compare morbidity among small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age), appropriate-for-gestational-age (AGA; birth weight 10th to 90th percentile; reference group), and large-for-gestational-age (LGA; birth weight greater than the 90th percentile) neonates in apparently uncomplicated pregnancies at term (37 weeks of gestation or greater). METHODS: This secondary analysis, derived from an observational obstetric cohort of 115,502 deliveries, included women with apparently uncomplicated pregnancies of nonanomalous singletons who had confirmatory ultrasound dating no later than the second trimester and who delivered between 37 0/7 and 42 6/7 weeks of gestation. We used two different composite neonatal morbidity outcomes: hypoxic composite neonatal morbidity for SGA and traumatic composite neonatal morbidity for LGA neonates. Log Poisson relative risks (RRs) with 95% CIs adjusted for potential confounding factors (nulliparity, body mass index, insurance status, and neonatal sex) were calculated. RESULTS: Among the 63,436 women who met our inclusion criteria, SGA occurred in 7.9% (n=4,983) and LGA in 8.3% (n=5,253). Hypoxic composite neonatal morbidity was significantly higher in SGA (1.1%) compared with AGA (0.7%; adjusted RR 1.44, 95% CI 1.07-1.93) but similar between LGA (0.6%) and AGA (adjusted RR 0.84, 95% CI 0.58-1.22). Traumatic composite neonatal morbidity was significantly higher in LGA (1.9%) than AGA (1.0%; adjusted RR 1.88, 95% CI 1.51-2.34) but similar in SGA (1.3%) compared with AGA (adjusted RR 1.28, 95% CI 0.98-1.67). CONCLUSION: Among women with uncomplicated pregnancies, hypoxic composite neonatal morbidity is more common with SGA neonates and traumatic-composite neonatal morbidity is more common with LGA neonates.

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