Risk factors and deliveries associated with preterm, severely small for gestational age fetuses.

Maternal and fetal risk factors and deliveries associated with 153 singleton, preterm, severely small for gestational age (SGA) fetuses were compared to the corresponding data of 153 next-born preterm appropriate for gestational age (AGA) fetuses matched for gestational age. Maternal history of previous delivery of an infant of SGA status, pre-eclampsia, hypertension without proteinuria, oligohydramnios, and fetal congenital anomalies were identified as risk factors for preterm, severely SGA deliveries. In the preterm, severely SGA group the rate for abdominal deliveries was 82%. Of these operations, 40% were emergency cesarean sections, many of which involved pre-eclampsia cases. If congenital malformations were excluded, perinatal mortality rate was 7% in the preterm SGA group and 4.6% in the preterm AGA group. Preterm, severely SGA fetuses constitute a perinatal risk group, which cannot be avoided. However, awareness of and familiarity with the risk factors associated with preterm, severely SGA cases can better equip the attending physician to consider appropriate perinatal care options.