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)