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Published on: November 20, 2015
SGA as a Risk Factor for Cerebral Palsy in Moderate to Late Preterm Infants: a System Review and Meta-analysis
Mengwen Zhao1, Hongmei Dai1, Yuanying Deng1
1Department of Pediatrics, the Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Insights
Small for gestational age (SGA) is a significant predictor of cerebral palsy (CP) in preterm infants born between 32-36 weeks gestation. This meta-analysis confirms a 2.34-fold increased risk of CP in these infants.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Perinatal Epidemiology
Background:
- Small for gestational age (SGA) is a known risk factor for cerebral palsy (CP) in term infants.
- Conflicting data exists regarding the association between SGA and CP in moderate to late preterm infants (32-36 weeks gestation).
Purpose of the Study:
- To investigate the relationship between SGA and CP in moderate to late preterm infants.
- To quantify the strength of this association using meta-analysis.
Main Methods:
- A systematic literature search was conducted in OVID (EMBASE, MEDLINE) and WANFANG databases.
- Seven studies (3 cohort, 4 case-control) were included in the meta-analysis.
- Random-effect models were used to pool study-specific risk estimates.
Main Results:
- A statistically significant association was found between SGA and CP in moderate to late preterm infants (OR: 2.34; 95% CI: 1.43-3.82).
- The association was stronger in subgroups: 34-36 weeks gestation (OR: 3.47), SGA < 2 SDs (OR: 3.48), and CP with malformations (OR: 3.00).
Conclusions:
- SGA is a reliable predictor for CP in moderate to late preterm infants.
- Further research is needed to elucidate the underlying mechanisms connecting SGA and CP.
Abstract:
Small for gestational age (SGA) is an established risk factor for cerebral palsy (CP) in term infants. However, there is conflicting data on the association between SGA and CP in moderate to late preterm infants. The aim of the article was to explore the relationship between SGA and CP in the moderate to late preterm infants and its strength by meta-analysis. We performed a system search in OVID (EMBASE and MEDLINE) and WANFANG from inception to May 2016. The study-specific risk estimates were pooled using the random-effect model. A total of seven studies were included in the meta-analysis, consisting of three cohort and four case-control studies. A statistically significant association was found between SGA and CP in moderate to late premature infants (OR: 2.34; 95% CI: 1.43-3.82). The association were higher in the several subgroups: 34-36 week gestational age (OR: 3.47; 95% CI: 1.29-9.31), SGA < 2SDs (OR: 3.48; 95% CI: 1.86-6.49), and malformation included in CP (OR: 3.00; 95% CI: 1.71-5.26). In moderate to late premature infants, SGA is a convenient and reliable predictor for CP. More studies are needed to explore the underlying mechanisms between SGA and CP association.
