SECOND TRIMESTER PREDICTION OF SMALL FOR GESTATIONAL AGE AND INTRAUTERINE GROWTH RESTRICTION

Objectives: To analyze second trimester risk factors to develop small for gestational age, and intrauterine growth restriction fetuses. Materials: We retrospectively analyzed neonatal and pregnancy outcomes of 5390 women, who delivered between 2007 and 2009 in a third level Clinic of North-East Italy, 2862 of which have performed a second trimester anomaly routine ultrasound in our center. Methods: We included in the study all AGA, SGA under the 10th neonatal weight centile at birth, and IUGR. We excluded all pregnancy related hypertensive disorders, twin pregnancies and all SGA without a known ultrasound before delivery to confirm IUGR. Data was analyzed by R(version 2.13.1), considering significant p < 0.05.Results: We found IUGR to be delivered significantly earlier than SGA and AGA.Moreover,We found a higher prevalence of nulliparity in SGA and IURG fetuses than AGA onces, and a significant higher prevalence of bilateral notch in SGA than AGA. IUGR present a significantly higher placental index than SGA and AGA. SGA fetuses at 20 gestational weeks present a significant higher value of umbilical artery PI and mean uterine arteries RI than AGA. In multivariate logistic regression analysis the second trimester factors to predict SGA at delivery are: mother age, nulliparity, academic title, PI of umbilical artery at 20 gestational weeks, mean RI of uterine arteries at 20 gestational weeks, and bilateral notch. In case of SGA the most predictive factors are: mother age, nulliparity, and bilateral notch at 20 gestational weeks. Conclusions: Clinical interview and ultrasound examination at 20 gestational weeks were capable to predict fetal growth potential and IUGR development.