Clinical markers for early diagnosis of small for gestational age births; a cross-sectional study

Introduction: Small for gestational age (SGA) births negatively impact neonatal outcomes. Objectives: This study aimed to evaluate the prevalence of SGA, its associated risk factors, maternal complications, biochemical markers, and ultrasound/Doppler findings to identify predictors for the early detection of SGA. Patients and Methods: A cross-sectional study was conducted involving 328 mother-newborn pairs (234 SGA; categorized as 90 mild, 96 moderate, and 48 severe fetal growth restriction [FGR]; 94 controls). Moreover, clinical, biochemical, histological, and immunomorphological variables were analyzed using SPSS version 26. Results: The placental mass and area were lower in cases of FGR compared to controls. Among these, moderate FGR (subgroup II) exhibited the lowest mass (422.4 g) and area (244 cm²). Poor maternal nutrition was observed in 75–83.3% of SGA infants, compared to only 5.1% of controls. Additionally, preeclampsia occurred more frequently in moderate (32.3%) and mild FGR (20.0%) than in controls (18.1%) (χ² = 9.164, P = 0.002). Besides, logistic regression analysis indicated that acute respiratory infection (ARI) was independently associated with reduced odds of being SGA (adjusted OR = 0.07, P = 0.016), while tumor necrosis factor alpha (TNF-α) expression remained a significant independent predictor (adjusted OR = 1.03, P<0.001). Lower estimated fetal weight (EFW), smaller abdominal circumference, and higher umbilical artery pulsatility index (PI) were predictive of SGA status, whereas the uterine artery PI lost significance. Placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels were lower in SGA infants (84.6 ± 29.2 pg/mL; 1.54 ± 0.42 ng/mL) compared to non-SGA infants (125.7 ± 31.6 pg/mL; 2.49 ± 0.95 ng/mL). Furthermore, SGA neonates exhibited higher rates of asphyxia (72.6%) and a greater need for resuscitation due to severe FGR (46.8%). Conclusion: Abdominal circumference, EFW, TNF-α levels, elevated umbilical artery PI, and low-PlGF are significant predictors of SGA. This finding accentuates the importance of a comprehensive assessment that integrates clinical, biochemical, and sonographic evaluations for early diagnosis and management.

Hali tarjima qilinmagan