Kazemier, B.Voskamp, B.Ravelli, A.Pajkrt, E.Groot, C.Mol, B.2015-12-032015-12-032015American Journal of Perinatology, 2015; 30(2):177-1860735-16311098-8785http://hdl.handle.net/2440/97118OBJECTIVE: Our aim was to study the competing risks of antepartum versus intrapartum/neonatal death in small for gestational age (SGA) and non-SGA fetuses. STUDY DESIGN: We performed a national cohort study using all singletons delivered between 36 and 42(6/7) weeks without hypertension, preeclampsia, diabetes, congenital anomalies, or noncephalic presentation from the Netherlands Perinatal Registry (1999-2007). The resultant cohort was divided in three groups based on birth weight by gestational age (SGA < P5 group, 61,021 deliveries; SGA P5-10 group, 58,902 deliveries; non-SGA group 1,168,523 deliveries). We compared the mortality risk of delivery with expectant management. RESULTS: Delivery was associated with more mortality than expectant management for 1 week from 39 weeks onward in the non-SGA group (relative risk [RR], 1.26; 95% confidence interval [CI], 1.05-1.50). For the SGA < P5, expectant management for 1 more week was associated with more mortality from 38 weeks onward although this only reached statistical significance from 40 weeks onward (RR, 2.46; 95% CI, 1.80-3.36). CONCLUSION: At 36 and 37 weeks, delivery is associated with a higher risk of mortality in SGA < P5 fetuses than expectant management. Delivery of SGA < P5 fetuses at 38 and 39 weeks is associated with the best perinatal outcome whereas for non-SGA fetuses this is at 39 to 40 weeks.enCopyright © 2015 by Thieme Medical PublishersSmall for gestational age; optimal timing delivery; antepartum death; neonatal deathJournal article003001778210.1055/s-0034-13817240003486288000102-s2.0-849398924292-s2.0-84901908976159287Mol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]