Detection of small-for-gestational-age infants with poor perinatal outcomes using individualized growth assessment

Objective: Our objective was to evaluate individualized growth assessment u sing the Rossavik growth model for detection of small-for-gestational-age ( SGA) infants with a poor perinatal outcome. Methods: Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 47 singleton SGA infants; Individual fetal growth curve standards for head and abdominal circumference, and weight were dete rmined from the data of two scans obtained before 25 weeks' menstrual age a nd separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index (GPRI) and Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes mechanical delivery, low Apgar score, abn ormal fetal heart rate (FHR) patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit (NICU) admission and mater nal complications were compared between SGA; infants with normal NGAS and t hose with abnormal NGAS. Results: Of the 47 fetuses studied, 27 had normal growth outcomes at birth and 20 showed evidence of intrauterine growth rest riction, based on NGAS. There were significant increases in mechanical deli veries, abnormal FHR patterns and meconium staining of amniotic fluid in ca ses of growth-restricted neonates, determined using the NGAS classification , when compared with events related to normally grown infants, However, the re were no significant differences in low Apgar score, neonatal acidosis, N ICU admission and maternal complications between the 2 groups. Conclusion, Individualized growth assessment should be useful for detection of SGA infa nts with poor perinatal outcomes.