Main Findings
In this cohort study of pregnancies with PPROM, SGA was diagnosed in 11% of the infants and we found that both the Hadlock and the FMF fetal growth charts are accurate predictors of SGA. However, the rate of FGR with the FMF was 45% versus 21% with the Hadlock chart. Both fetal growth standards were not statistically significant predictors of severe neonatal outcomes, but only 2 of the 12 SGA neonates were complicated by severe neonatal outcomes.
We have previously reported the rate of FGR (21%) in this cohort of pregnancies with PPROM.(27) The rate of FGR and SGA in PPROM depends on the definition, population, gestational age, and weight chart utilized. In a large multicenter randomized trial that included more than 1800 pregnancies with PPROM from 34-36 weeks of gestation randomized to immediate delivery versus expectant management, an SGA rate of 3.6% was reported. (28) Another large multi-center observational study from France that included 702 gestations, evaluating the effect of the duration of latency in pregnancies with PPROM from 24-32 weeks, only reported on those with birthweight < 3rdpercentile (7.5% of their cohort).(29) Neither of these studies described which weight charts were used. A small cohort from Italy of 69 pregnancies with PPROM form 24-31 weeks reported rates of FGR of 39% and SGA rates of 26%.(30) and they utilized an Italian neonatal birthweight chart.(31)