Renal function is impaired in small for gestational age premature infants

Small for gestational age (SGA) premature infants are at increased risk for complications. We aimed to evaluate if SGA infants are at higher risk for presenting renal insufficiency in the newborn period compared to appropriate for gestational age (AGA) premature infants.

We conducted a retrospective case-control study of infants ≤ 34 weeks gestation. Markers of renal function based upon the Acute Kidney Injury Network were compared between both groups.

Twenty SGA infants were compared to twenty AGA infants matching in sex and gestational age. SGA infants had higher serum creatinine on day of life (DOL) 1 (p = 0.014) and DOL 3 (p = 0.05) and a higher overall maximum creatinine concentration (p = 0.013). They were also more likely to have an increase in serum creatinine more than 0.3 mg/dL in a 48-h period (OR: 7.8, p = 0.008) and increase in serum creatinine more than 50% in a 48-h period (OR: 12.4, p = 0.002). Urine output (mL/kg/h) was significantly less in the SGA group on DOL 3 (p = 0.002) and DOL 7 (p = 0.017).

SGA infants are at increased risk for renal insufficiency during the neonatal period, thereby implying the need for special considerations in their fluid and medication management.