Aim: To compare combined perinatal outcome and maternal characteristics between detected and undetected small for gestational age foetus.

Materials and Methods: It is a prospective, observational cohort study done atmaternity referral perinatal centre with about 8000 deliveries per year. The sample comprised of mothers who delivered SGA neonates. Data was collected as maternal characteristics including age, body mass index, parity, risk factors for SGA, type of labour, mode of delivery, induction of labour rate, gestational age at delivery, rate of presumed fetal zcompromise leading to caesarean section assisted vaginal deliveries, low Apgar’s, cord pH and composite neonatal morbidity between detected and undetected SGA. Composite neonatal morbidity includes respiratory distress, sepsis, neonatal hypoglycaemia requiring IV fluid, severe birth asphyxia and NICU admission for greater than 48 hours and neonatal seizure.

Results: Prevalence of SGA was 6.4% with detection rate of 50%, significant risk factor for SGA was present in 37% cases so recognition of risk factor improves detection rate of SGA. Higher rate of induction and caesarean section rate were seen in detected SGA. Instrumental delivery rate was more in undetected SGA. Un detected SGA had more signs of fetal distress during labour, low cord pH and low Apgar, but NICU admissions were more in detected SGA. There was no significant perinatal mortality in term SGA babies.

Conclusions: Every unit should have protocol to identify and manage SGA fetus for better outcome.

Keywords: Small for Gestational Age; Perinatal Outcome; Maternal Characteristics.