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Type: Journal article
Title: Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study
Author: McCowan, L.
Roberts, C.
Dekker, G.
Taylor, R.
Chan, E.
Kenny, L.
Baker, P.
Moss-Morris, R.
Chappell, L.
North, R.
Citation: BJOG: an International Journal of Obstetrics and Gynaecology, 2010; 117(13):1599-1607
Publisher: Blackwell Publishing Ltd
Issue Date: 2010
ISSN: 1470-0328
Organisation: SCOPE Consortium
Statement of
L. M. E. McCowan, C. T. Roberts, G. A. Dekker, R. S. Taylor, E. H. Y. Chan, L. C. Kenny, P. N. Baker, R. Moss-Morris, L. C. Chappell, R. A. North on behalf of the SCOPE Consortium
Abstract: OBJECTIVE: To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. DESIGN: Prospective, multicentre cohort study. SETTING: Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. POPULATION: The 3513 nulliparous participants of the SCOPE study. METHODS: Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identifed using logistic regression. MAIN OUTCOME MEASURES: Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA. RESULTS: Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan. CONCLUSIONS: Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.
Keywords: Birthweight
customised birthweight centile
fetal growth restriction
risk factors
small for gestational age
Rights: © 2010 The Authors Journal compilation, © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
DOI: 10.1111/j.1471-0528.2010.02737.x
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Obstetrics and Gynaecology publications

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