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Large-for-gestational-age fetuses have an increased risk for spontaneous preterm birth

Journal of Perinatology volume 39, pages 1050–1056 (2019)Cite this article

Subjects

Abstract

Objective

Our aim was to investigate the association between large-for-gestational-age and the risk of spontaneous preterm birth.

Study Design

We studied nulliparous women with a singleton gestation using data from the Dutch perinatal registry from 1999 to 2010. Neonates were categorized according to the Hadlock fetal weight standard, into 10th to 90th percentile, 90th to 97th percentile, or above 97th percentile. Outcomes were preterm birth <37+0 weeks and preterm birth between 25+0–27+6 weeks, 28+0–30+6 weeks, 31+0–33+6 weeks, and 34+0–36+6 weeks.

Results

We included 547,418 women. The number of spontaneous preterm births <37 weeks was significantly increased in the large-for-gestational-age group ( > p97) compared with fetuses with a normal growth (p10–p90) (11.3% vs. 7.3%, odds ratio (OR) 1.8; 95% CI 1.7–1.9). The same results were found when limiting analyses to women with certain pregnancy duration (after in vitro fertilization).

Conclusion

Large-for-gestational-age increases the risk of spontaneous preterm delivery from 25 weeks of gestation onwards.

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Acknowledgements

We thank all Dutch midwives, obstetricians, neonatologists, and other perinatal healthcare providers for the registration of perinatal information and the Foundation of The Netherlands Perinatal Registry (https://www.perined.nl) for permission to use the registry data.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Maud D. van Zijl, Martijn A. Oudijk, Anita C. J. Ravelli, Eva Pajkrt & Brenda M. Kazemier

  2. Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Anita C. J. Ravelli

  3. Department of Obstetrics and Gynecology, School of Medicine, Monash University, Melbourne, VIC, Australia

    Ben W. J. Mol

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  1. Maud D. van Zijl
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Correspondence to Maud D. van Zijl.

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Prof. dr. B.W. Mol reports consultancy for ObsEva, Merck and Guerbet.

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van Zijl, M.D., Oudijk, M.A., Ravelli, A.C.J. et al. Large-for-gestational-age fetuses have an increased risk for spontaneous preterm birth. J Perinatol 39, 1050–1056 (2019). https://doi.org/10.1038/s41372-019-0361-6

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