Abstract
Objective:
To determine if the use of a sex-specific standard to define small-for-gestational age (SGA) will improve prediction of stillbirth.
Study design:
We performed a retrospective cohort study of singleton pregnancies excluding anomalies, aneuploidy, undocumented fetal sex or birthweight. SGA was defined as birthweight <10th percentile by the non-sex-specific and sex-specific Alexander standards. The association between SGA and stillbirth using these standards was assessed using logistic regression.
Result:
Among 57 170 pregnancies meeting inclusion criteria, 319 (0.6%) pregnancies were complicated by stillbirth. The area under the receiver operating characteristic curve for the prediction of stillbirth was greater for the sex-specific compared to the non-sex-specific standard (0.83 vs 0.72, P<0.001).
Conclusion:
Our findings suggest adoption of a sex-specific standard for diagnosis of SGA as it is more discriminative in identifying the SGA fetus at risk for stillbirth.
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Acknowledgements
AST was supported by NIH T32 Grant 5T32HD055172-05 George Macones (PI) and the Washington University Institute of Clinical and Translational Sciences Grant UL1TR000448 Bradley Evanoff (PI).
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Presented as a poster presentation at the 33rd annual meeting of the Society of Maternal Fetal Medicine, 11 February 2013 to 16 February 2013, San Francisco, CA. Abstract #299. Accepted by the Washington University School of Medicine IRB: July 2012, Project ID #20120605.
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Trudell, A., Cahill, A., Tuuli, M. et al. Stillbirth and the small fetus: use of a sex-specific versus a non-sex-specific growth standard. J Perinatol 35, 566–569 (2015). https://doi.org/10.1038/jp.2015.17
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DOI: https://doi.org/10.1038/jp.2015.17
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