Neonatal Morbidity in Late Preterm Infants Associated with Intrauterine Growth Restriction

Area of Science:

• Neonatalogy
• Perinatology
• Pediatric Health

Background:

• Late preterm (LP) infants (34-36 weeks gestation) represent a significant proportion of neonatal admissions.
• Intrauterine growth restriction (IUGR) is a known risk factor for adverse neonatal outcomes.
• Comparing morbidity between IUGR and appropriate for gestational age (AGA) LP infants is crucial for targeted care.

Purpose of the Study:

• To compare neonatal morbidity between late preterm infants with Intrauterine growth restriction (IUGR) and those appropriate for gestational age (AGA).
• To identify specific morbidities that are more prevalent in IUGR late preterm neonates.

Main Methods:

• A 2-year prospective study utilizing Neonatal Intensive Care Unit (NICU) data from a tertiary maternity hospital.
• Inclusion criteria focused on late preterm neonates; congenital anomalies and genetic syndromes were excluded.
• Comparison of neonatal morbidity between IUGR and AGA late preterm infants, with calculation of Odds Ratios (OR) and 95% Confidence Intervals (CI).

Main Results:

• Out of 336 LP neonates, 88 were IUGR and 206 were AGA (control group).
• The IUGR group exhibited significantly higher rates of hypoglycemia, polycythemia, feeding intolerance, birth asphyxia, and seizures.
• Secondary sepsis showed higher morbidity in the IUGR group, though not statistically significant; no differences in hyperbilirubinemia or neonatal deaths were observed.

Conclusions:

• Late preterm infants with IUGR face a substantially increased risk of neonatal morbidity compared to their AGA counterparts.
• Specific morbidities like hypoglycemia, feeding intolerance, and birth asphyxia are key concerns for IUGR LP infants.
• These findings underscore the need for vigilant monitoring and tailored interventions for late preterm infants identified with IUGR.