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Mortality and morbidity pattern in small-for-gestational age and appropriate-for-gestational age very preterm babies:
Taj Muhammad1, Asmat Ara Khattak, Shafiq-ur-Rehman
1Department of Paediatrics, Lady Reading Hospital, Peshawar, Pakistan. dr.tajmahsud2000@gmail.com
Insights
Very preterm infants who are small-for-gestational age (SGA) face higher mortality and morbidity compared to appropriate-for-gestational age (AGA) peers. These findings highlight the need for specialized care and monitoring of SGA preterm infants.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Critical Care
Background:
- Very preterm infants are a vulnerable population with increased risks of morbidity and mortality.
- Understanding the specific patterns of morbidity and mortality in this group is crucial for optimizing care.
- Comparing Small-for-Gestational Age (SGA) and Appropriate-for-Gestational Age (AGA) very preterm infants can reveal distinct risk factors.
Purpose of the Study:
- To compare the mortality and morbidity patterns between Small-for-Gestational Age (SGA) and Appropriate-for-Gestational Age (AGA) very preterm infants.
- To identify specific health outcomes associated with SGA status in very preterm neonates.
- To inform clinical management strategies for improving outcomes in this high-risk group.
Main Methods:
- A hospital-based prospective cohort study comparing 100 SGA and 100 AGA very preterm infants with similar gestational ages.
- Data collection included gestational age, birth weight, mortality, and various biochemical and clinical morbidity markers.
- Statistical analysis utilized descriptive statistics and inferential tests (SPSS version 15) to compare outcomes between the two groups.
Main Results:
- SGA infants had significantly lower birth weight compared to AGA infants (p = 0.001).
- SGA infants exhibited higher mortality rates (40% vs. 22%, p = 0.006) and increased morbidity, including hyperbilirubinemia (67% vs. 51%, p = 0.02) and hypocalcemia (24% vs. 10%, p=0.02).
- The disparity in mortality was more pronounced in infants with gestational age ≤31 weeks, with 71.4% mortality in SGA versus 39.3% in AGA infants.
Conclusions:
- Very preterm SGA infants experience significantly higher mortality and morbidity than their AGA counterparts.
- Gestational age and biochemical markers are critical factors to consider in the therapeutic management of SGA preterm infants.
- Special attention to these factors is essential for improving hospital-based outcomes for very preterm SGA infants.
Background:
Very preterm babies are important group of paediatric babies who require special attention. These babies are known to have increased risk of morbidity and mortality. Studying the morbidity and mortality pattern for this important paediatric group can help in better understanding of their care in the hospital settings. Objective of the study was to compare the mortality and morbidity pattern in Small-for-gestational age and appropriate-for-gestational age very preterm babies. This hospital based prospective (cohort) study was conducted at the department of Paediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from March 2008 to April 2009.
Methods:
One hundred Small-for-gestational age (SGA) live born very preterm babies were compared with 100 appropriate-for-gestational age (AGA) very preterm babies having similar gestational ages. Information regarding gestational age, birth weight, mortality, and morbidity (in terms of various biochemical and clinical markers) were recorded on a pre-designed questionnaire. Data analysis was done using SPSS version 15. Results were interpreted in terms of descriptive (mean, proportions, standard deviation) and inferential statistical tests (with p-values).
Results:
There was no difference between the two groups (SGA vs. AGA) with regards to gestational age and gender of the babies The mean weight of SGA babies was significantly lower as compared to AGA babies (1.1 +/- 0.16 Kg Vs 1.5 +/- 0.2 Kg; p = 0.001). As compared to AGA babies, the SGA babies had a higher mortality (40% vs. 22%, p = 0.006), and higher morbidity in terms of hyperbilirubinaemia (67% vs. 51%, p = 0.02) and hypocalcaemia (24% vs. 10%, p=0.02). The difference in the mortality between the two groups was more prominent in babies with gestational age < or =31 weeks (71.4% for SGA as compared to 39.3% for AGA ery preterm babies with gestational age < or =31 weeks).
Conclusion:
Very preterm SGA infants have significantly higher mortality and morbidity in comparison to the AGA babies. In deciding for therapeutic management of these babies, they need special attention in terms of factors as gestational age and the biochemical markers, to improve the outcome for these babies in the hospital settings.
