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Mortality and morbidity in preterm small-for-gestational-age infants: a population-based study
Sorina Grisaru-Granovsky1, Brian Reichman, Liat Lerner-Geva
1Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, The Hebrew University Medical School of Jerusalem, Jerusalem, Israel. granovs@012.net.il
American Journal of Obstetrics and Gynecology
|October 11, 2011
Summary
The severity of small-for-gestational-age (SGA) impacts outcomes for very-low-birthweight infants. Greater growth restriction correlates with higher risks of mortality and major neonatal morbidities.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Research
Background:
- Small-for-gestational-age (SGA) infants, particularly those with very low birthweight (VLBW), face significant risks.
- Understanding the impact of varying degrees of growth restriction is crucial for neonatal care.
Purpose of the Study:
- To assess how the severity of intrauterine growth restriction influences mortality and major neonatal morbidities in VLBW SGA infants.
Main Methods:
- Population-based observational study using the Israel National VLBW Infant Database (1995-2007).
- Included infants born between 24-31 weeks' gestation with birthweight (BW) ≤ 50th percentile, excluding major malformations.
- Analyzed four BW percentile groups: <3rd, 3rd-<10th, 10th-<25th, and 25th-50th (reference), using logistic regression.
Main Results:
- Infants with BW 3rd-<10th percentile showed increased odds of retinopathy of prematurity (OR 2.07), bronchopulmonary dysplasia (OR 2.52), necrotizing enterocolitis (OR 1.32), and mortality (OR 2.37).
- The risk for these adverse outcomes was even higher in infants with BW <3rd percentile.
Conclusions:
- The severity of growth restriction serves as a significant clinical marker for the degree of risk.
- This finding aids in stratifying risk for neonatal mortality and morbidities in VLBW SGA infants.
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