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Extremely growth-retarded infants: is there a viability centile?
Vishwanath M Kamoji1, Jon S Dorling, Bradley N Manktelow
1Neonatal Unit, Level 5 Kensington Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, United Kingdom. vmkamoji@doctors.org.uk
Pediatrics
|August 3, 2006
Summary
Extremely premature infants with severe growth restriction (less than the 2nd birth weight centile) have poor survival rates. This suggests a need to reconsider management strategies for these high-risk neonates.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Public Health
Background:
- Extremely premature infants face higher mortality risks.
- Intrauterine growth retardation (IUGR) further elevates poor outcomes.
- Limited data exist for managing combined extreme prematurity and severe IUGR.
Purpose of the Study:
- Identify a birth weight centile cutoff for increased mortality in premature infants with IUGR.
- Determine a viability cutoff for extremely premature and growth-retarded neonates.
Main Methods:
- Evaluated 8228 preterm infants (22-32 weeks gestation) born in the Trent region, UK (1994-2003).
- Categorized infants into 6 weight centiles.
- Assessed survival, respiratory support duration, neonatal unit length of stay, and age at death.
Main Results:
- Survival was significantly reduced for infants born at <= 28 weeks gestation with birth weight below the 2nd centile.
- Stillbirth rates were inversely related to birth weight centile in infants born before 29 weeks gestation.
- 4448 infants were male, 6194 from singleton pregnancies, and 2887 born at <= 28 weeks gestation.
Conclusions:
- Infants born at <= 28 weeks gestation with birth weight < 2nd centile have poor survival.
- Management strategies for this high-risk group warrant reconsideration.
