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Clinical outcome of small for gestational age preterm infants
I Ruys-Dudok van Heel1, R de Leeuw
1Department of Neonatology, Academic Medical Center, Amsterdam, The Netherlands.
Insights
Preterm infants born small for gestational age (SGA) experience higher mortality and morbidity, including severe respiratory distress and developmental issues, compared to appropriate for gestational age (AGA) infants. These findings highlight critical considerations for delivery timing in SGA neonates.
Area of Science:
- Neonatology
- Perinatal Medicine
- Pediatric Growth Disorders
Background:
- Small for gestational age (SGA) preterm infants represent a vulnerable population.
- Understanding the specific morbidities and mortality risks associated with SGA preterm infants is crucial for clinical management.
Purpose of the Study:
- To compare the clinical outcomes, including mortality and morbidity, of preterm SGA infants versus preterm appropriate for gestational age (AGA) infants.
- To identify specific complications and long-term handicaps in preterm SGA neonates.
Main Methods:
- Retrospective review of data from 55 preterm SGA infants and 55 matched preterm AGA infants.
- Comparison of incidence rates for perinatal hypoxia, gastrointestinal problems, infections, hematological issues, respiratory distress syndrome (RDS), mortality, and handicaps.
Main Results:
- SGA infants exhibited increased rates of perinatal hypoxia, gastrointestinal problems, infections, and hematological issues.
- Mortality was significantly higher in SGA infants (21.8%) compared to AGA infants (7.2%).
- Severe respiratory distress syndrome (RDS) and higher rates of handicaps (19% vs. 9%) were observed in the SGA group.
Conclusions:
- Preterm SGA infants face substantially higher mortality and morbidity risks than their AGA counterparts.
- The combination of prematurity and severe intrauterine growth restriction significantly impacts neonatal outcomes.
- These findings are vital for informing decisions regarding the optimal timing of delivery for preterm SGA infants.
Abstract:
Data from 55 preterm SGA infants and 55 preterm AGA infants matched for gestational age and sex were reviewed retrospectively. An increased incidence of perinatal hypoxia (30 vs. 18), gastrointestinal problems, minor infections (27 vs. 9), hematological problems and increased mortality (21.8% vs. 7.2%) was observed in the SGA infants. The incidence of HMD was higher in the AGA group (not significant), but the HMD was much more severe in the SGA group. Mortality as a result of HMD was significantly higher in the SGA group. The percentage of handicapped children is 19% in the SGA group and 9% in the AGA group. The percentages of severely handicapped children are 4.8% and 2.3% respectively. The combination of prematurity and severe intrauterine growth retardation in the SGA group caused a higher mortality and morbidity than was seen in their AGA controls. This clinical performance of SGA preterm infants is important especially for those who have to decide at what moment such a child should be delivered by caesarean section.