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Published on: January 7, 2018
Neonatal outcomes of late-preterm birth associated or not with intrauterine growth restriction
Cristiane Ortigosa Rocha1, Roberto Eduardo Bittar, Marcelo Zugaib
1Department of Obstetrics, University of Sao Paulo, Av. dr Eneas de Carvalho Aguiar, 945, Cerqueira Cesar, Sao Paulo SP, cep 05412-002, Brazil.
Insights
Late-preterm infants with intrauterine growth restriction (IUGR) face higher risks for neonatal complications, including longer hospital stays and hypoglycemia, compared to appropriate-for-gestational-age (AGA) infants. However, mortality rates were similar in this study.
Area of Science:
- Neonatology
- Perinatology
- Pediatric Research
Background:
- Late-preterm infants (34-36 6/7 weeks GA) are a vulnerable population.
- Intrauterine growth restriction (IUGR) is a significant concern in fetal development.
- Understanding neonatal outcomes for IUGR infants is crucial for clinical management.
Purpose of the Study:
- To compare neonatal morbidity and mortality between late-preterm infants with IUGR and appropriate-for-gestational-age (AGA) infants.
- To identify specific complications associated with IUGR in the late-preterm period.
Main Methods:
- Retrospective analysis of 50 singleton pregnancies with IUGR and 36 singleton pregnancies with AGA infants.
- Infants were delivered between 34 and 36 6/7 weeks of gestational age (GA).
- Statistical comparison using chi-squared analysis, Fisher's exact test, and Kruskal-Wallis test.
Main Results:
- IUGR infants experienced longer nursery stays and neonatal intensive care unit (NICU) hospitalizations.
- Higher risk of intraventricular hemorrhage and hypoglycemia observed in IUGR infants.
- No significant differences in transient tachypnea of the newborn, apnea, sepsis, thrombocytopenia, or hyperbilirubinemia.
Conclusions:
- Late-preterm IUGR infants exhibit a significantly higher risk of neonatal complications compared to late-preterm AGA infants.
- While mortality was not increased, specific morbidities warrant closer monitoring and management.
- Further research into optimizing care for this high-risk group is recommended.
Abstract:
Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) infants of the comparable gestational ages (GAs). Methods. We retrospectively analyzed neonatal morbidity and mortality of 50 singleton pregnancies involving fetuses with IUGR delivered between 34 and 36 6/7 weeks of GA due to maternal and/or fetal indication. The control group consisted of 36 singleton pregnancies with spontaneous preterm delivery at the same GA, in which the infant was AGA. Categorical data were compared between IUGR and AGA pregnancies by X(2) analysis and Fisher's exact test. Ordinal measures were compared using the Kruskal-Wallis test. Results. The length of stay of newborns in the nursery, as well as the need for and duration of hospitalization in the neonatal intensive care unit, was longer in the group with IUGR. Transient tachypnea of the newborn or apnea rates did not differ significantly between the IUGR and AGA groups. IUGR infants were found to be at a higher risk of intraventricular hemorrhage. No respiratory distress syndrome, pulmonary hemorrhage or bronchopulmonary dysplasia was observed in either group. The frequency of sepsis, thrombocytopenia and hyperbilirubinemia was similar in the two groups. Hypoglycemia was more frequent in the IUGR group. No neonatal death was observed. Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.
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