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Infants weighing <1500 g: better born too small or too soon?

Isabella Crippa1, Anna Locatelli, Sara Consonni

  • 1Department of Obstetrics and Gynecology, University of Milano-Bicocca, San Gerardo Hospital, Fondazione MBBM, Monza, Italy.

American Journal of Perinatology
|May 31, 2012
PubMed

Insights

Gestational age at delivery, not intrauterine growth restriction, significantly impacts adverse neurological outcomes in very low-birth-weight infants. This finding is crucial for predicting neurodevelopmental outcomes in preterm neonates.

Area of Science:

  • Neonatalogy
  • Neurodevelopmental Pediatrics
  • Perinatology

Background:

  • Intrauterine growth restriction (IUGR) is a known risk factor for adverse neonatal outcomes.
  • The impact of IUGR on long-term neurological outcomes in very low-birth-weight (VLBW) infants requires further clarification.

Purpose of the Study:

  • To investigate the association between intrauterine growth and neurological outcomes at 12-24 months in VLBW infants (<1500 g).

Main Methods:

  • Retrospective cohort study of 240 VLBW neonates, classified as IUGR or appropriate for gestational age.
  • Correlation of perinatal variables with a composite adverse outcome (neonatal death or adverse neurodevelopmental outcome [ANDO]) at 12-24 months.

Main Results:

  • Neurological follow-up was available for 163 of 214 surviving infants; 28% experienced ANDO.
  • Multivariate analysis revealed gestational age at delivery as the sole independent predictor of composite adverse outcome (p < 0.001).
  • Diagnosis of IUGR was not significantly associated with adverse outcomes.

Conclusions:

  • Gestational age at delivery is a critical factor influencing neurodevelopmental outcomes in VLBW preterm infants.
  • IUGR status did not independently predict adverse neurological outcomes in this cohort.
Abstract

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