Small for gestational age and intrauterine growth restriction

Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity. The risk of mortality or neonatal morbidity is higher among neonates in small for gestational age (SGA)-discordant twins than in appropriate-for-gestational-age (AGA)-discordant twins. Identification of SGA remains important since the likelihood of IUGR is significantly higher in severe cases. More reliable distinction of IUGR has also enabled the inclusion of growth restriction into the ‘Classification of stillbirth by relevant condition at death’ system. A prior history of placenta-mediated disease is also a risk factor for a subsequent SGA neonate. Timely detection of SGA remains crucial since this will inform both the clinician and the mother that the pregnancy is at increased risk, and also enable more detailed investigation to inform timing for delivery. One of the most important aspects of SGA management is an understanding of the decisions relevant to delivery.