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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Impact of intrauterine growth restriction on preterm lung disease

Arun Sasi1, Vinita Abraham1, Miranda Davies-Tuck2

  • 1Monash Newborn, Monash Children's Hospital, Melbourne, Vic., Australia.

Acta Paediatrica (Oslo, Norway : 1992)
|September 25, 2015
PubMed

Insights

Intrauterine growth restriction (IUGR) significantly increases the risk of chronic lung disease (CLD) and death in preterm infants. IUGR infants require more respiratory support and home oxygen at discharge.

Area of Science:

  • Neonatal Medicine
  • Respiratory Medicine
  • Pediatric Pulmonology

Background:

  • Intrauterine growth restriction (IUGR) is a significant contributor to prematurity and associated morbidities.
  • Infants born with IUGR and small for gestational age (SGA) status face increased risks.
  • Understanding the pulmonary impact of IUGR in extremely preterm infants is crucial.

Purpose of the Study:

  • To evaluate the impact of IUGR on short-term respiratory outcomes in preterm infants (<32 weeks).
  • To compare respiratory morbidity in infants with IUGR (birthweight <10th centile) versus appropriate for gestational age (AGA) controls.
  • To analyze outcomes based on gestational age subgroups (<28 and ≥28 to <32 weeks).

Main Methods:

  • Retrospective study design.
  • Inclusion of 153 IUGR infants and 306 non-IUGR (AGA) controls.
  • Primary outcomes: chronic lung disease (CLD), CLD or death, and need for home oxygen at discharge.

Main Results:

  • IUGR infants exhibited significantly higher rates of CLD (45% vs. 17%), death (16% vs. 4.6%), and CLD or death (46% vs. 21.5%) compared to AGA controls.
  • Higher rates of home oxygen dependency (13.7% vs. 6.5%) and prolonged respiratory support were observed in the IUGR group.
  • IUGR was identified as the strongest predictor for CLD (aOR 8.4) and CLD or death (aOR 12.7) across all gestations.

Conclusions:

  • Intrauterine growth restriction is a major risk factor for adverse short-term pulmonary outcomes in preterm infants.
  • IUGR is associated with increased rates of CLD, combined CLD or death, and oxygen dependency at discharge.
  • These findings underscore the importance of monitoring and managing respiratory health in preterm infants with IUGR.
Abstract

Keywords:
Chronic lung diseaseIntrauterine growth restrictionPrematurity

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