Related Experiment Video
Updated: Aug 1, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Morbidity and Mortality in Small for Gestational Age Infants at 22 to 29 Weeks' Gestation
Nansi S Boghossian1, Marco Geraci2, Erika M Edwards3,4,5
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; nboghoss@mailbox.sc.edu.
Insights
Small for gestational age (SGA) infants born prematurely face increased risks for mortality and several morbidities, with outcomes varying by gestational age. These risks are not uniform across the entire premature gestational age range.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Public Health
Background:
- Premature infants born small for gestational age (SGA) may experience different health outcomes compared to non-SGA infants.
- Understanding these differences is crucial for optimizing neonatal care and improving survival rates.
Purpose of the Study:
- To determine the comparative risks of mortality and morbidities for SGA infants versus non-SGA infants born between 22 and 29 weeks' gestation.
- To analyze how these risks vary across different gestational ages within this premature range.
Main Methods:
- Utilized data from 156,587 infants across 852 US centers (2006-2014) from the Vermont Oxford Network.
- Defined SGA as birth weight below the 10th percentile for gestational age and sex.
- Employed binomial generalized additive models to calculate adjusted relative risks for various outcomes by gestational age and SGA status.
Main Results:
- SGA infants showed increased risks for mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease.
- The risk of patent ductus arteriosus varied, decreasing in early gestation and increasing later for SGA infants.
- Severe intraventricular hemorrhage risk was lower in SGA infants at 24-25 weeks' gestation, while early-onset sepsis risk was similar for most gestational ages.
Conclusions:
- Small for gestational age status is linked to additional mortality and morbidity risks in preterm infants.
- The magnitude of these risks associated with SGA is dependent on the infant's specific gestational age at birth.
Objectives:
To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation.
Methods:
Data were collected (2006-2014) on 156 587 infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight <10th centile for gestational age (GA) in days. Binomial generalized additive models with a thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA.
Results:
Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also at increased risks of mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. These risks of adverse outcomes, however, were not homogeneous across the GA range. Early-onset sepsis was not different between the 2 groups for the majority of GAs, although severe intraventricular hemorrhage was decreased among SGA infants for only gestational week 24 through week 25.
Conclusions:
SGA was associated with additional risks to mortality and morbidities, but the risks differed across the GA range.
