Moderate psychosocial problems identified during early pregnancy in 78 women were found to predispose for various “complications” during gestation, but not for prematurity or obstetrical complications during delivery. However, from a normal postnatal status the children of these mothers demonstrated a significantly unfavorable somatic, as well as psychomotoric development, until the age of 4. Pregnant women with certain psychosocial problems must be early identified and property attended to in order to preclude an adverse child development.

Questions about the effectiveness of psychosocial interventions in pregnancy are important in any overall evaluation of antenatal care. This article reviews the evidence as to the positive benefit on a range of pregnancy outcomes provided by 35 published and unpublished randomized controlled trials of psychosocial interventions.

Samples and methods vary in constructing birthweight charts. Introduction of ultrasound dating affects the distribution of gestation, increases the proportion of preterm births, and reduces postterm and small-for-gestational-age (SGA) births. The need for standardized charts is emphasized. Preferably such charts ought to be sex- and parity-specific, also taking into account the mother's previous pregnancy outcome in terms of birthweight. The risks associated with being bom SGA involve various morbidity as well as short- and long-term survival.

Antenatal risk factors in combination with symphysis-fundus distance can identify pregnancies with small infants, who can be divided in genetically small, malformed, and malnourished infants. Only the last category benefit from fetal surveillance. Maternal diseases, pregnancy complications (hypertension), and environmental factors (smoking) are connected to malnourished small infants.

The development of various symphysis fundus (SF) growth charts and the use of SF height measurements in the diagnosis of small-for-gestational-age (SGA) births and the prediction of newborn complications are reviewed. Measurement precision and accuracy are also discussed. It is concluded that further research of this simple, low cost, harmless, and widespread technology to detect fetal growth disturbances in routine prenatal care is warranted.

Ultrasound estimation of fetal weight or ultrasound measurement of fetal abdomen alone enables identification of small-for-gestational-age fetuses. A prerequisite for this is a reliable dating of pregnancy, which is provided by a routine ultrasound screening in the first half of gestation. The fetal growth can be followed by serial fetometric measurements. As a standard, charts of intrauterine growth based on the ultrasonic measurement can be used. As a secondary diagnostic test for monitoring fetal health in pregnancies suspected of intrauterine growth retardation, Doppler ultrasound evaluation of fetal and uteroplacental hemodynamics provided useful for early detection of imminent fetal distress.

Efficacy of ultrasonography to detect fetal growth retardation is reviewed. Ultrasound dating is held as a prerequisite. Abdominal anthropometry is reported to reflect fetal growth best. Efficacy of symphysis-fundus (SF) height measurements is reviewed similarly. Proposed protocols that include ultrasound and SF height measurements and other maternal characteristics with known prognostic properties are reported. Preferably, both kinds of measurements should be analyzed longitudinally.

Intrauterine growth retardation is associated with high risk of perinatal asphyxia. The neonatal mortality rate of small-for-gestational-age (SGA) infants (birthweight ≤ 2 SD) in Sweden decreased from 5.6% in 1973 to 2.0% in 1987. During the same period, the number SGA infants with postnatal asphyxia (5 min Apgar score <7) decreased from 10% to 5%. Based on antenatal diagnosis of fetal growth retardation, an optimal time of delivery reduces the risk of major neurological and developmental sequelae of the individual infant.