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Stillbirth and the small fetus: use of a sex-specific versus a non-sex-specific growth standard

Journal of Perinatology volume 35, pages 566–569 (2015)Cite this article

Subjects

Abstract

Objective:

To determine if the use of a sex-specific standard to define small-for-gestational age (SGA) will improve prediction of stillbirth.

Study design:

We performed a retrospective cohort study of singleton pregnancies excluding anomalies, aneuploidy, undocumented fetal sex or birthweight. SGA was defined as birthweight <10th percentile by the non-sex-specific and sex-specific Alexander standards. The association between SGA and stillbirth using these standards was assessed using logistic regression.

Result:

Among 57 170 pregnancies meeting inclusion criteria, 319 (0.6%) pregnancies were complicated by stillbirth. The area under the receiver operating characteristic curve for the prediction of stillbirth was greater for the sex-specific compared to the non-sex-specific standard (0.83 vs 0.72, P<0.001).

Conclusion:

Our findings suggest adoption of a sex-specific standard for diagnosis of SGA as it is more discriminative in identifying the SGA fetus at risk for stillbirth.

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Acknowledgements

AST was supported by NIH T32 Grant 5T32HD055172-05 George Macones (PI) and the Washington University Institute of Clinical and Translational Sciences Grant UL1TR000448 Bradley Evanoff (PI).

Author information

Authors and Affiliations

  1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, St Louis, MO, USA

    A S Trudell, A G Cahill, M G Tuuli & G A Macones

  2. Department of Obstetrics and Gynecology, University of South Florida 2 Tampa General Circle, Tampa, FL, USA

    A O Odibo

Authors
  1. A S Trudell
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  2. A G Cahill
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  3. M G Tuuli
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  4. G A Macones
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  5. A O Odibo
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Corresponding author

Correspondence to A S Trudell.

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The authors declare no conflict of interest.

Additional information

Presented as a poster presentation at the 33rd annual meeting of the Society of Maternal Fetal Medicine, 11 February 2013 to 16 February 2013, San Francisco, CA. Abstract #299. Accepted by the Washington University School of Medicine IRB: July 2012, Project ID #20120605.

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Trudell, A., Cahill, A., Tuuli, M. et al. Stillbirth and the small fetus: use of a sex-specific versus a non-sex-specific growth standard. J Perinatol 35, 566–569 (2015). https://doi.org/10.1038/jp.2015.17

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