Does the antenatal detection of small-for-gestational-age babies influencetheir two-year outcomes?

The aim of this paper is to determine whether antenatal detection of small- for-gestational-age (SGA) babies influences 2-year outcomes. All low-birth- weight (<2500g) infants born in South-East Thames region, England from Sept ember 1, 1992 to August 31, 1993 were identified at birth. Antenatal "suspi cion" and ultrasound assessment confirming growth restriction was categoriz ed as "detection" of SGA. Postnatally, infants were classified as SCA ii th ey had a birth weight for given gestation below the 10th centile. At 2 year s, those below 32 weeks' gestation and a random 25% sample of infants of 32 weeks' gestation or more underwent pediatric assessments. Of 49,787 births , 3456 (6.9%) were of low birth weight. One thousand four hundred and fifty one (42.5%) were SGA, of whom 611 (42%) were detected antenatally by ultra sound scan. At 2 years, 1008 (75.8%) of 1358 expected infants were assesse d, 379 (37.6%) were SGA at birth, and 188 (49.6%) were confirmed antenatall y. Although undetected infants had higher mean birth weights and gestationa l ages, they had a higher proportion of perinatal deaths (12.6 vs. 6.4%, RR 1.96: Cl 1.32-2.86) than detected infants. At 2 years, detected SCA infant s had smaller head circumferences (p = 0.026), a higher prevalence of febri le convulsions (8.0 vs. 3.1%: p = 0.040) and lower scores on the locomotor (DQA) scale of Griffith's developmental test (p = 0.021) compared with unde tected SCA infants. Despite detected SGA Fetuses having lower weights and g estation at birth than undetected fetuses, they had significantly lower mor tality without a parallel increase in severe 2-year neuro-developmental, cl inical, or growth morbidity.