Small-for-Gestational-Age Infant Predicts Stillbirth in Subsequent Pregnancy

NEW YORK (Reuters Health) Feb 19 - Women who have delivered a small-for-gestational-age (SGA) infant are at least twice as likely as other women to experience a stillbirth in subsequent pregnancy. Nonetheless, the absolute risk of stillbirth is relatively low, according to a report published in The New England Journal of Medicine for February 19.

The subsequent risk of stillbirth is particularly high if the SGA infant was delivered preterm, senior author Dr. Sven Cnattingius, from the Karolinska Institute in Stockholm, and colleagues note.

The findings come from a study of more than 400,000 Swedish women who gave birth to first and second consecutive singleton infants between 1983 and 1997. A total of 1842 stillbirths were noted during the first pregnancies and 1062 occurred during the second pregnancies.

Compared with non-SGA infants born at term, term SGA infants raised the odds of future stillbirth by 2.1 times. For SGA infants born at 32 to 36 weeks of gestation or before 32 weeks, the odds ratio for stillbirth increased were 3.4 and 5.0, respectively.

Women whose first infant was stillborn were 2.5-times more likely than other women to experience a subsequent stillbirth.

Still, the findings indicate that even in the highest risk group the absolute risk of having a stillbirth was small, according to a related editorial.

"Pregnant women and their physicians should be reassured by the fact that even when the previous delivery occurred at less than 32 weeks of gestation and the infant was severely SGA, the probability of a late fetal death in the current pregnancy was still less than 2%," note Dr. Jun Zhang and Dr. Mark A. Klebanoff, from the National Institutes of Health in Bethesda, Maryland.

N Engl J Med 2004;350:777-785.

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