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Journal of Pregnancy
Volume 2011, Article ID 293516, 5 pages
http://dx.doi.org/10.1155/2011/293516
Research Article

Labour and Neonatal Outcome in Small for Gestational Age Babies Delivered Beyond 36+0 Weeks: A Retrospective Cohort Study

1Department of Gynaecology and Obstetrics, Bronovo Hospital, Bronovolaan 5, 2597 AX The Hague, The Netherlands
2Department of Obstetrics, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
3Department of Obstetrics, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands

Received 29 August 2010; Revised 24 October 2010; Accepted 8 November 2010

Academic Editor: Sean Blackwell

Copyright © 2011 K. E. Boers et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Small for gestational age (SGA) is associated with increased neonatal morbidity and mortality. At present, evidence on whether these pregnancies should be managed expectantly or by induction is lacking. To get insight in current policy we analysed data of the National Dutch Perinatal Registry (PRN). Methods. We used data of all nulliparae between 2000 and 2005 with a singleton in cephalic presentation beyond 36+0 weeks, with a birth weight below the 10th percentile. We analysed two groups of pregnancies: (I) with isolated SGA and (II) with both SGA and hypertensive disorders. Onset of labour was related to route of delivery and neonatal outcome. Results. Induction was associated with a higher risk of emergency caesarean section (CS), without improvement in neonatal outcome. For women with isolated SGA the relative risk of emergency CS after induction was 2.3 (95% Confidence Interval [CI] 2.1 to 2.5) and for women with both SGA and hypertensive disorders the relative risk was 2.7 (95% CI 2.3 to 3.1). Conclusion. Induction in pregnancies complicated by SGA at term is associated with a higher risk of instrumental deliveries without improvement of neonatal outcome. Prospective studies are needed to determine the best strategy in suspected IUGR at term.