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Ventilatory requirements for respiratory distress syndrome in small-for-gestational-age infants
P J Thompson1, A Greenough, H R Gamsu
1Department of Child Health, King's College Hospital, London, United Kingdom.
Insights
Fetal growth retardation in very preterm infants does not protect against severe respiratory distress syndrome (RDS). Small-for-gestational age (SGA) infants showed increased need for ventilation due to RDS and higher mortality rates.
Area of Science:
- Neonatology
- Perinatal Medicine
- Pediatric Respiratory Medicine
Background:
- Very preterm infants are at high risk for respiratory complications.
- Small-for-gestational age (SGA) infants may have different physiological responses to prematurity.
- The protective effect of fetal growth retardation against respiratory distress syndrome (RDS) in extremely premature infants is debated.
Purpose of the Study:
- To investigate whether fetal growth retardation protects very preterm, small-for-gestational age (SGA) infants against severe respiratory distress syndrome (RDS).
- To compare ventilatory requirements and outcomes between SGA and appropriate-for-gestational age preterm infants.
Main Methods:
- Retrospective analysis of 135 very preterm, small-for-gestational age (SGA) infants.
- Comparison with gestational age- and gender-matched controls.
- Analysis of mechanical ventilation duration, need for ventilation due to RDS, and mortality rates.
Main Results:
- SGA infants showed a higher incidence of requiring mechanical ventilation for RDS compared to controls.
- No significant difference in the median duration of mechanical ventilation was observed between SGA and control groups.
- Mortality rates were significantly greater in the SGA group.
Conclusions:
- Fetal growth retardation does not confer protection against severe respiratory distress syndrome (RDS) in very preterm infants.
- SGA status is associated with an increased risk of RDS and poorer outcomes in this population.
- Further research into the specific mechanisms underlying RDS in SGA preterm infants is warranted.
Abstract:
Neonatal ventilatory requirements and outcome were examined in 135 very preterm, small-for-gestational age (SGA) infants to determine whether fetal growth retardation protects against severe respiratory distress syndrome (RDS) in very immature infants. Their results were compared to those from gestational age- and gender-matched controls. Although there was no significant difference in the median duration of mechanical ventilation between the two groups, more SGA infants required ventilation and were ventilated because of RDS. In a subgroup also matched for mode of delivery, there was no significant difference between the proportion of SGA infants requiring mechanical ventilation for RDS compared to their matched controls. The mortality was greater in the SGA group. We conclude that fetal growth retardation does not protect against severe RDS.