Small for gestational age fetus: clinical, anamnestic, and perinatal aspects
Sidelnikova M.D., Kan N.E., Tyutyunnik V.L., Soldatova E.E., Zolotareva A.P., Alieva L.E.
Objective. To identify the clinical characteristics and maternal history factors associated with adverse perinatal outcomes among pregnancies complicated by a small for gestational age fetus.
Materials and methods. This retrospective cohort study included 405 pregnant women with a prenatal diagnosis of a small for gestational age fetus who delivered at the V.I. Kulakov NMRC for OG&P between 2020 and 2025. This study included patients with singleton full-term pregnancies. Cases of multiple pregnancies, surrogacy, preterm birth, and pregnancies with diagnosed chromosomal abnormalities or fetal malformations were excluded from the study. The overall cohort was divided into two groups: those with favorable and those with unfavorable perinatal outcomes. An unfavorable outcome was defined as a neonatal condition with critical prognostic significance and a range of associated neonatal conditions (pathological adaptation). Clinical and anamnestic data, pregnancy and childbirth characteristics, and early neonatal period were assessed. Statistical analysis was performed using JASP (Student's t-test, Mann-Whitney U test, chi-square test, Fisher's exact test, p<0.05).
Results. The study found that 24% of pregnant women carrying a fetus diagnosed as small for gestational age experienced adverse perinatal outcomes, despite having no apparent signs of fetal distress during antenatal surveillance. The analysis revealed that differences in pregnancy outcomes were specifically associated with small for gestational age rather than the demographic or reproductive characteristics of the patients. Significant risk factors for adverse outcomes included low prenatal birth weight, history of spontaneous miscarriages and placenta-associated pregnancy complications, gynecological diseases (uterine fibroids and uterine anomalies), and pregnancy complications (threatened miscarriage, retrochorial hematoma, anemia, gestational hypertension, and oligohydramnios). Antenatal fetal weight assessment has limited prognostic value.
Conclusion. A small for gestational age fetus is a clinically heterogeneous condition with varying prognoses. Almost a quarter of small-for-gestational-age fetuses experience adverse perinatal outcomes, which represents a significant proportion and necessitates the search for new diagnostic options to identify these fetuses.
Authors' contributions. Sidelnikova M.D., Kan N.E., Tyutyunnik V.L., Soldatova E.E., Zolotareva A.P., Alieva L.E. – conception and design of the study, data acquisition, review of relevant literature, material processing and analysis, statistical analysis, drafting of the manuscript, editing of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
Ethical Approval. The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P.
Generative Artificial Intelligence. No artificial intelligence tools were used in the preparation of this manuscript.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Sidelnikova M.D., Kan N.E., Tyutyunnik V.L., Soldatova E.E., Zolotareva A.P., Alieva L.E.
Small for gestational age fetus: clinical, anamnestic, and perinatal aspects.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (9): 78-86 (in Russian)
https://dx.doi.org/10.18565/aig.2026.107
Keywords
small for gestational age fetus
fetal growth restriction
perinatal outcomes
clinical and anamnestic factors
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Received 01.04.2026
Accepted 01.09.2026
About the Authors
Maria D. Sidelnikova, Obstetrician-Gynecologist at the 1st Obstetric Physiological Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(903)220-45-13, m_sidelnikova@oparina4.ru,https://orcid.org/0000-0002-0805-4703
Natalia E. Kan, Professor, Dr. Med. Sci., Honored Scientist of the Russian Federation, Deputy Director General for Research – Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow,
Ac. Oparina str., 4, kan-med@mail.ru, Researcher ID: B-2370-2015, SPIN-code: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600,
https://orcid.org/0000-0001-5087-5946
Victor L. Tyutyunnik, Professor, Dr. Med. Sci., Honored Doctor of the Russian Federation, Leading Researcher at the Center of Scientific and Clinical Researches, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, tioutiounnik@mail.ru, Researcher ID: B-2364-2015, SPIN-code: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Ekaterina E. Soldatova, PhD, Researcher at the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, katerina.soldatova95@bk.ru, https://orcid.org/0000-0001-6463-3403
Anna P. Zolotareva, PhD candidate, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4; Obstetrician-Gynecologist, Day Hospital Department for Pregnancy Examination, Primorsky Krai Perinatal Center, 690042, Russia, Vladivostok, Mozhayskaya str., 1B, serebriakovanna@gmail.com, https://orcid.org/0000-0001-7014-2627
Leyla E. Alieva, PhD Student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparina str. 4, leylaalieva00@mail.ru, https://orcid.org/0009-0008-3417-6721
Corresponding author: Maria D. Sidelnikova, m_sidelnikova@oparina4.ru
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