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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Impact of fetal growth restriction on mortality and morbidity in a very preterm birth cohort

Jennifer Zeitlin1, Mayass El Ayoubi, Pierre-Henri Jarreau

  • 1INSERM, UMR S953, IFR 69, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, UPMC Université Paris, Paris, France. jennifer.zeitlin@inserm.fr

The Journal of Pediatrics
|October 20, 2010
PubMed

Insights

Small for gestational age (SGA) infants born very preterm face higher mortality risks, especially those below the 25th percentile. Lower birthweight is consistently linked to poor outcomes, regardless of pregnancy complications.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Epidemiology

Background:

  • Small for gestational age (SGA) is a significant concern in preterm births.
  • Identifying precise risk factors for mortality and morbidity in very preterm infants is crucial for clinical management.

Purpose of the Study:

  • To evaluate the impact of small for gestational age (SGA) on very preterm mortality and morbidity.
  • To determine if different birthweight percentile thresholds affect these outcomes.
  • To investigate if the cause of preterm birth modifies the effects of SGA.

Main Methods:

  • Analysis of a cohort of 4525 very preterm infants (24-31 weeks gestation) from 10 European regions.
  • Outcomes assessed included mortality, severe intraventricular hemorrhage, cystic periventricular leukomalacia, and bronchopulmonary dysplasia (BPD).
  • Birthweight percentiles were categorized, and analyses were stratified by pregnancy complications.

Main Results:

  • Infants with birthweights below the 25th percentile had significantly higher mortality rates compared to those between the 50th-74th percentile.
  • Bronchopulmonary dysplasia (BPD) risk decreased with increasing birthweight.
  • No significant association was found between SGA and intraventricular hemorrhage or periventricular leukomalacia.

Conclusions:

  • A birthweight percentile cutoff of 25% effectively identifies very preterm infants at increased risk of mortality.
  • Bronchopulmonary dysplasia (BPD) risk is better described as a continuous measure related to birthweight.
  • Lower birthweight is independently associated with adverse outcomes in very preterm infants, irrespective of pregnancy complications.
Abstract

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