Neonatal complications in small-for-gestational age neonates.

A prospective case-control study was carried out in 118 severely small-for-gestational age (SGA) infants and in 118 control infants born during 1985 in the catchment area of the University Central Hospital of Turku to investigate the neonatal complication rate in SGA infants during modern obstetric and neonatal care. All SGA infants had a birth weight below the 2.5th percentile in our fetal growth curve and the control infants were matched for gestational age and mode of delivery. Neonatal complications were found in 42% of SGA neonates compared to 18% of control infants. Hypoglycemia, polycythemia and abnormal neurologic symptoms were more frequently found in SGA neonates than in control neonates. Asphyxia was found in 16% of SGA infants and in 8.5% of control infants. A five-fold risk for hypoglycemia and a eight-fold risk for abnormal neonatal neurologic signs in SGA infants were found. SGA boys had more often asphyxia (22% versus 12%) and hypoglycemia (25% versus 5%) than SGA girls. The antenatal diagnosis of SGA infant was made in 35 cases (30%). Of these diagnosed infants 14 were delivered by cesarean section (39%), while the cesarean section rate in all SGA infants was 27%. Although antenatal diagnosis of poor intrauterine growth did not decrease the neonatal complication rate, the antenatal diagnosis resulted in more active intervention during delivery. The SGA infants still run an increased risk for complications during delivery and neonatal period and need special attention.