Second Trimester LGA as a Predictor of Adverse Perinatal Outcomes: Does Timing of Fetal Overgrowth Matters?

Abstract

Objectives: The aim of this study was to evaluate the association of large for gestational age (LGA) fetuses diagnosed ultrasonographically in the second trimester with adverse perinatal outcomes and to determine the impact of the timing of fetal overgrowth on neonatal outcomes. Accordingly, we investigated whether pregnancies with LGA diagnosed in the second trimester differed in terms of perinatal complications compared to those diagnosed in the third trimester.

Methods: This retrospective cohort study was conducted with pregnant women who presented to the Perinatology Department of Ankara Etlik City Hospital and gave birth to macrosomic fetuses. Patients were grouped as those who were not diagnosed with LGA antenatally and those who were diagnosed with LGA on ultrasound examination in the second and third trimesters.

Results: The pregnant women diagnosed with LGA in the second trimester had a higher mean age compared to the AGA group, and the LGA group showed the highest mean age in the third trimester (P = .010). The rate of newborns with APGAR score <7 at 1 minute was significantly higher in the second trimester LGA group compared to the AGA group (P = .029).

Conclusion: This study found that LGA cases diagnosed in the second trimester were associated with significantly higher rates of adverse perinatal outcomes compared to those diagnosed in the third trimester. The findings suggest that the timing of fetal growth may be a determinant not only for birth weight but also for neonatal morbidity.