Abstract
Objective
To evaluate whether early term labor induction for suspected intrauterine growth restriction
(weeks 37–39) improves neonatal outcome for small-for-gestational-age (SGA) neonates.
Study design
Delivery room data for 2004–2008 from a single tertiary medical center were linked
to neonatal discharge data from the same institution. Data were limited to all singleton,
liveborn SGA neonates born at 37–42 weeks of gestation and their mothers. Births with
known congenital anomalies were excluded. Women undergoing induction of labor for
suspected growth restriction between 37 and 39 weeks’ gestation (early induction SGA)
were compared with women who gave birth to term SGA neonates without early induction.
SGA (<10th percentile for gestational age and gender) was used as a surrogate for
intrauterine growth restriction. Associations between early term labor induction and
neonatal morbidities were estimated using logistic regression.
Results
A total of 2378 SGA neonates meeting study criteria were identified. Of these, 445
underwent early term induction and 1933 were in the non-early induction SGA group.
Intrauterine demise among term (37–42 weeks) SGAs occurred in one case at 37 weeks.
Early term induction for SGA was associated with an increased risk of cesarean delivery.
Several neonatal complications, including hyperbilirubinemia, hypoglycemia and respiratory
complications were more prevalent in the early induction SGA group. The increased
odds for neonatal complications persisted after controlling for possible confounders.
Conclusions
Early term induction for SGA fetuses results in an increased risk of cesarean deliveries
as well as neonatal metabolic and respiratory complications, with no apparent neonatal
benefit.
Keywords
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Article info
Publication history
Published online: October 03, 2013
Accepted:
September 15,
2013
Received in revised form:
August 21,
2013
Received:
April 23,
2013
Identification
Copyright
© 2013 Published by Elsevier Inc.
