Obstetric interventions and perinatal asphyxia in growth retarded term infants.

Background: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies.

Methods: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat.

Results: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3-fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25% of the SGA pregnancies and 10% of those with asymmetric fetal growth had been eligible for close antenatal fetal monitoring.

Conclusion: With a moderate increase in interventions at delivery, perinatal outcome was highly favorable for term infants with a weight for gestational age, weight for length or skinfold for weight below the 10th percentile in this population of Scandinavian parous mothers.