Large-for-gestational-age fetuses have an increased risk for spontaneous preterm birth

Maud D. van Zijl*, Martijn A. Oudijk, Anita C.J. Ravelli, Ben W.J. Mol, Eva Pajkrt, Brenda M. Kazemier

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objective: Our aim was to investigate the association between large-for-gestational-age and the risk of spontaneous preterm birth. Study Design: We studied nulliparous women with a singleton gestation using data from the Dutch perinatal registry from 1999 to 2010. Neonates were categorized according to the Hadlock fetal weight standard, into 10th to 90th percentile, 90th to 97th percentile, or above 97th percentile. Outcomes were preterm birth <37+0 weeks and preterm birth between 25+0–27+6 weeks, 28+0–30+6 weeks, 31+0–33+6 weeks, and 34+0–36+6 weeks. Results: We included 547,418 women. The number of spontaneous preterm births <37 weeks was significantly increased in the large-for-gestational-age group (> p97) compared with fetuses with a normal growth (p10–p90) (11.3% vs. 7.3%, odds ratio (OR) 1.8; 95% CI 1.7–1.9). The same results were found when limiting analyses to women with certain pregnancy duration (after in vitro fertilization). Conclusion: Large-for-gestational-age increases the risk of spontaneous preterm delivery from 25 weeks of gestation onwards.

Original languageEnglish
Pages (from-to)1050-1056
Number of pages7
JournalJournal of Perinatology
Issue number8
Early online date2 Apr 2019
Publication statusPublished - 1 Aug 2019

Bibliographical note

We thank all Dutch midwives, obstetricians, neonatologists, and other perinatal healthcare providers for the registration of perinatal information and the Foundation of The Netherlands Perinatal Registry ( for permission to use the registry data.

Data Availability Statement

Supplementary information The online version of this article (https:// contains Supplementary
Material, which is available to authorized users.


  • epidemology
  • risk factors


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