Morbidity and mortality patterns in small-for-gestational age infants born preterm

Area of Science:

• Neonatalogy
• Perinatology
• Pediatric Critical Care

Background:

• Premature neonates born small-for-gestational age (SGA) may experience greater adverse effects than those born appropriate-for-gestational age (AGA).
• Understanding the comparative morbidity and mortality in these groups is crucial for optimizing neonatal care.

Purpose of the Study:

• To compare the morbidity and mortality rates between SGA and AGA neonates born with low gestational age (GA).
• To identify specific risks associated with SGA status in preterm infants.

Main Methods:

• A 9-year study of preterm infants (GA 24-31 weeks) hospitalized in a neonatal intensive care unit (NICU).
• Assessment of SGA status association with neonatal death and major morbidities including CLD, IVH, ROP, NEC, RDS, PDA, and sepsis.
• Multiple logistic regression analysis was employed to evaluate these associations.

Main Results:

• Small-for-gestational age (SGA) neonates showed a significantly higher incidence of chronic lung disease (CLD) (57.1% vs 29.3%).
• Mortality rates were substantially higher in SGA neonates (33.3% vs 17% for AGA), particularly in subgroups (24.1% vs 6.3% for GA 28-31 weeks).
• SGA status was independently associated with increased mortality (OR 3.4) and CLD (OR 3.9) in logistic regression.

Conclusions:

• Small-for-gestational age (SGA) neonates born between 24-31 weeks GA face elevated risks for developing chronic lung disease (CLD).
• Neonatal death risk is significantly higher in SGA preterm infants compared to AGA preterm infants of similar gestational age.