The prevalence and pregnancy-related outcomes of small-for-gestational-age newborns in Johannesburg, South Africa

Abstract Background: Small-for-gestational-age (SGA) newborns are those whose birth weight is less than the 10th percentile for their gestational age. SGA is associated with a high risk of morbidity and mortality during the perinatal period. The objective of this study was to determine the prevalence and perinatal outcomes of SGA newborns. Method: The study involved 291 singleton newborns who were born small for gestational age between 33 weeks and 0 days and 42 weeks and 6 days at a large public hospital in South Africa. Neonates who are small for gestational age were identified from the birth register using the Intergrowth-21 chart. Data on the perinatal outcomes of SGA newborns were collected from their mothers’ maternity records and analysed using descriptive statistics. Results: During the study period, there were a total of 7,837 births, of which 10.6% (834) were SGA. Among the SGA babies, the majority were male (56.0%), and about half of them had low birth weight (49.9%). Most (83.5%) of SGA newborns were born at term, while 16.5% were born preterm. Approximately two-thirds of the SGA newborns (71.5%) were delivered by caesarean section, with foetal compromise being the reason for the caesarean delivery in 69.7% of cases. Almost all SGA newborns (96.6%) had APGAR scores of 7 or higher at five minutes. Approximately 29.5% of the neonates were admitted to the neonatal nursery, and one out of 291 SGA newborns died within the first 24 hours of life. Conclusion: One in ten neonates born at a large urban hospital in South Africa is small for gestational age. Although SGA status is linked to a higher incidence of caesarean delivery, most of these newborns do not demonstrate adverse perinatal outcomes, indicating that many may be constitutionally small rather than pathologically small for gestational age.--