dc.contributor.author |
Cowan, F Joyce |
|
dc.contributor.author |
McKinlay, Christopher JD |
|
dc.contributor.author |
Taylor, Rennae S |
|
dc.contributor.author |
Wilson, Jess |
|
dc.contributor.author |
McAra-Couper, Judith |
|
dc.contributor.author |
Garrett, Nick |
|
dc.contributor.author |
O'Brien, Andrea |
|
dc.contributor.author |
McCowan, Lesley ME |
|
dc.coverage.spatial |
Australia |
|
dc.date.accessioned |
2022-05-08T23:22:28Z |
|
dc.date.available |
2022-05-08T23:22:28Z |
|
dc.date.issued |
2021-06 |
|
dc.identifier.citation |
(2021). Australian and New Zealand Journal of Obstetrics and Gynaecology, 61(3), 339-346. |
|
dc.identifier.issn |
0004-8666 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/59061 |
|
dc.description.abstract |
<h4>Background</h4>Timely detection of small for gestational age (SGA) fetuses is important for reducing severe perinatal morbidity and mortality, and better tools are needed to detect SGA in maternity care.<h4>Aim</h4>We evaluated the effect of the introduction of the Perinatal Institute's Growth Assessment Protocol (GAP) in the Counties Manukau Health region, South Auckland, New Zealand, on antenatal detection of SGA and maternal and perinatal outcomes.<h4>Materials and methods</h4>Uncontrolled before and after study in women booked under hospital community midwife care with a singleton, non-anomalous pregnancy. Antenatal detection of SGA (birthweight <10th customised centile) was compared pre-GAP (2012, N = 1105) and post-GAP (2017, N = 1082). Composite adverse neonatal outcome was defined as neonatal unit admission >48 h, five-minute Apgar score <7, and/or any ventilation. Analyses were adjusted for maternal age, body mass index, deprivation, smoking and ethnicity.<h4>Results</h4>SGA rates were similar across epochs (13.8% vs 12.9%) but antenatal detection of SGA increased from 22.9% (35/153) to 57.9% (81/140) post-GAP (adjusted odds ratio (aOR) = 4.8, 95% CI 2.82-8.18). Rates of induction of labour and caesarean section increased between epochs but were similar in SGA, non-SGA, and detected and non-detected SGA subgroups. Among SGA babies, there was some evidence that antenatal detection of SGA may be associated with lower composite adverse neonatal outcome (detected SGA: aOR 0.44 95% CI 0.17-1.15; non-detected SGA: aOR = 1.81 95% CI 0.73-4.48; interaction P = 0.03). Pre-term birth did not appear to be influenced by GAP.<h4>Conclusion</h4>Implementation of GAP was associated with a nearly five-fold increase in SGA detection without increasing obstetric intervention for SGA. |
|
dc.format.medium |
Print-Electronic |
|
dc.language |
eng |
|
dc.publisher |
Wiley |
|
dc.relation.ispartofseries |
The Australian & New Zealand journal of obstetrics & gynaecology |
|
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.subject |
Humans |
|
dc.subject |
Pregnancy Outcome |
|
dc.subject |
Cesarean Section |
|
dc.subject |
Gestational Age |
|
dc.subject |
Pregnancy |
|
dc.subject |
Infant |
|
dc.subject |
Infant, Newborn |
|
dc.subject |
Infant, Small for Gestational Age |
|
dc.subject |
Maternal Health Services |
|
dc.subject |
New Zealand |
|
dc.subject |
Female |
|
dc.subject |
fetal growth restriction |
|
dc.subject |
growth charts |
|
dc.subject |
prenatal care |
|
dc.subject |
small for gestational age |
|
dc.subject |
Pediatric |
|
dc.subject |
Perinatal Period - Conditions Originating in Perinatal Period |
|
dc.subject |
Clinical Research |
|
dc.subject |
Infant Mortality |
|
dc.subject |
Preterm, Low Birth Weight and Health of the Newborn |
|
dc.subject |
Prevention |
|
dc.subject |
Reproductive health and childbirth |
|
dc.subject |
3 Good Health and Well Being |
|
dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Obstetrics & Gynecology |
|
dc.subject |
BIRTH-WEIGHT CENTILES |
|
dc.subject |
RISK |
|
dc.subject |
IDENTIFICATION |
|
dc.subject |
FETUSES |
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dc.subject |
INFANTS |
|
dc.subject |
1114 Paediatrics and Reproductive Medicine |
|
dc.subject |
1117 Public Health and Health Services |
|
dc.title |
Detection of small for gestational age babies and perinatal outcomes following implementation of the Growth Assessment Protocol at a New Zealand tertiary facility: An observational intervention study. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1111/ajo.13283 |
|
pubs.issue |
3 |
|
pubs.begin-page |
339 |
|
pubs.volume |
61 |
|
dc.date.updated |
2022-04-18T05:07:57Z |
|
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
33341930 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/33341930 |
|
pubs.end-page |
346 |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Journal Article |
|
pubs.subtype |
Observational Study |
|
pubs.elements-id |
832814 |
|
pubs.org-id |
Liggins Institute |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
School of Medicine |
|
pubs.org-id |
Obstetrics and Gynaecology |
|
dc.identifier.eissn |
1479-828X |
|
pubs.record-created-at-source-date |
2022-04-18 |
|
pubs.online-publication-date |
2020-12-19 |
|