Screening investigations in small-for-gestational-age near-term and term infants
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The aims of this study are to examine how frequently near-term and term small-for-gestational-age (SGA) infants were investigated in our clinical practice, whether being born less than the third centile for weight increased the yield of positive investigations, and whether there were additional characteristics in infants with positive investigations. This retrospective cohort study was compiled using a database of a large maternity network, using the search near term and term gestational age (greater than or equal to 35 weeks) over a span of 4 years. SGA babies were further filtered into less than the tenth centile and third centile. Out of a population of 30,461 infants in the study period, 3437 (11.3%) SGA infants were identified. Four hundred fifteen SGA infants (12.1%) underwent screening investigations, of which 49 infants (11.8%) yielded a positive investigation. 27.2% of karyotypes, 12.8% of cranial ultrasounds and 0.4% of urine CMV tests showed positive results in < 10th centile group. Being born less than the third centile for weight did not increase the yield of positive investigations. Most infants with positive investigations had an additional maternal or neonatal characteristic or risk factor present.
What is Known:
• Small-for-gestational-age (SGA) infants have an increased risk of short- and long-term complications.
• Whilst the causes for SGA are multifactorial, there has been a tendency to undertake screening investigations like Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes group of viruses (TORCH) screening and cranial ultrasounds in the neonatal period.
What is New:
• Comprehensive study investigating the rates of screening in near-term and term SGA population.
• The yield of screening tests for near-term and term SGA infants without additional antenatal and postnatal characteristics is low.
KeywordsIUGR Cranial ultrasound Karyotype Cytomegalovirus
Appropriate for gestational age
Body mass index
Birthing outcome summary
Hypoxic ischaemic encephalopathy
Herpes simplex virus
Intrauterine growth restriction
Neonatal intensive care unit
Polymerase chain reaction
Special care nursery
Small for gestational age
Toxoplasma, others, rubella, cytomegalovirus, herpes virus
We thank Amanda Kendel, Monash Women’s Information Team Support Officer, for her help in retrieving data from the Birthing Outcome Summary (BOS) database.
MBK collected data, carried out the analyses of the collected data, drafted the initial manuscript, critically reviewed the manuscript and approved the final manuscript as submitted.
AP collected data, provided constructive comments to the manuscript. She approved the final manuscript as submitted.
AM formulated the research question, critically reviewed the manuscript and approved the final manuscript as submitted.
Compliance with ethical standards
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration or comparable ethical standards. The study qualified as a quality assurance project under the hospital human research ethics committee framework.
Conflict of interest
The authors declare that they have no conflict of interest.
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