Perinatal outcome of pregnancies complicated with extreme birth weights at term |
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Authors: | Uri Chavkin Tamar Wainstock Ruslan Sergienko Asnat Walfisch |
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Institution: | 1. Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel;2. Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel;3. Soroka University Medical Center, Beer-Sheva, Israel |
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Abstract: | Objective: The objective of this study is to investigate whether an abnormal birthweight at term, either small for gestational age (SGA,?5th centile for gestational age) or large for gestational age (LGA,?>?95th centile for gestational age), is a risk factor for perinatal complications as compared with birthweight appropriate for gestational age (AGA).Methods: A population-based retrospective cohort analysis of all singleton pregnancies delivered between 1991 and 2014 at Soroka Medical Center. Congenital malformations and multiple pregnancies were excluded. A multivariable generalized estimating equation regression model was used to control for maternal clusters and other confounders.Results: During the study period, 228,242 births met the inclusion criteria, of them 91% were AGA (n?=?207,652), 4.7% SGA, and 4.3% LGA. SGA significantly increased the risk for perinatal mortality (aOR 5.6, 95%CI 4.5–6.8) and low 5-min Apgar scores (aOR 2.2, 95%CI 2.0–2.4), while LGA did not. SGA and LGA were both significant risk factors for cesarean delivery. LGA was significantly associated with shoulder dystocia and post-partum hemorrhage (aOR =13.6, 95%CI 10.9–17.0, and aOR 1.7, 95%CI 1.2–2.6, respectively).Conclusions: Extreme birthweights at term are significantly associated with adverse maternal and neonatal outcomes. As opposed to SGA, LGA is not independently associated with perinatal mortality. |
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Keywords: | Apgar score cesarean delivery large for gestational age macrosomia perinatal mortality small for gestational age term pregnancy |
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