• Stas Vashevnik, Susan Walker, and Michael Permezel.
• Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia. stas1975@optusnet.com.au
• Aust N Z J Obstet Gynaecol. 2007 Aug 1; 47 (4): 302-6.

AimsTo compare the risk of stillbirth and neonatal death in small-for-gestational-age (SGA), appropriate-for-gestational-age (AGA) and large-for-gestational-age (LGA) fetuses and neonates.DesignRetrospective analysis of 662 043 births and outcomes recorded in the Victorian Perinatal Data Collection Unit (1992-2002).Inclusion CriteriaBirths in Victoria in 1992-2002.Exclusion CriteriaMultiple pregnancy and congenital birth defects.Main Outcome MeasuresBirths, stillbirths and neonatal deaths at each week of gestation after 23 weeks were stratified by birthweight into appropriate, small and large for gestational age. Stillbirth risk per 1000 ongoing pregnancies and neonatal death rate per 1000 live births were calculated.ResultsFor the AGA group, the overall stillbirth risk was 2.88 per 1000 and neonatal death rate was 1.35 per 1000. In the LGA group, these were 2.62 and 1.83 per 1000, respectively. The slight increase in neonatal death rate among LGA fetuses was confined to those delivered after 28 weeks gestation. In the SGA group, the stillbirth risk and neonatal death rate were 15.1 and 3.99 per 1000, respectively.ConclusionThe risk of stillbirth per week of gestational age and neonatal death rates do not differ significantly between AGA and LGA fetuses and neonates. The SGA fetus is at significantly greater risk of both stillbirth and neonatal death, particularly with advancing gestational age.

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