Recurrent small for gestational age birth: perinatal risks and outcomes.

The risk of recurrent small for gestational age birth, as well as maternal and fetal-neonatal characteristics associated with recurrence, was examined in 174 mothers of consecutively delivered small for gestational age infants followed through an additional 240 livebirths. There was a twofold and fourfold increase in the risk for small for gestational age birth after one and two small for gestational age births, respectively. Although an intervening average for gestational age birth decreased the risk of recurrence, these women remained at increased risk over the general population. Given the history of a previous small for gestational age birth, perinatal risks and outcomes considered individually would not improve the prediction of recurrence. However, the significantly higher frequency of these variables, considered as a group, among mothers with recurrent small for gestational age birth suggests an association with underlying maternal disease, for example, chronic hypertension, substance use and abuse, more severe fetal-neonatal compromise, and recurrent small for gestational age birth. Recurrent small for gestational age birth should initiate a search for persistent, underlying maternal disease.