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Updated: Aug 30, 2025

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Small for Gestational Age Affects Outcomes on Singletons and Inborn Births in Extremely Preterm Infants: A Japanese

Hideyo Suenaga1, Hidehiko Nakanishi2, Atsushi Uchiyama3

  • 1Department of pediatrics, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.

American Journal of Perinatology
|August 30, 2022
PubMed

Insights

Small for gestational age (SGA) infants born extremely preterm face higher risks for conditions like bronchopulmonary dysplasia and developmental delays. Specific gestational ages increase the likelihood of cerebral palsy and visual impairment in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Developmental Pediatrics

Background:

  • Extremely preterm infants born small for gestational age (SGA) have distinct outcomes compared to appropriate for gestational age (AGA) infants.
  • Understanding these differences is crucial for optimizing care and long-term prognosis.

Purpose of the Study:

  • To compare the short- and long-term clinical outcomes of extremely preterm SGA infants versus AGA infants in Japan.
  • To identify specific gestational age ranges within SGA infants that are associated with increased risks for adverse outcomes.

Main Methods:

  • Retrospective analysis of 434 SGA and 1,716 AGA infants born between 22 to 27 weeks gestational age (GA).
  • Follow-up for 3 years, comparing clinical characteristics and outcomes.
  • Statistical analysis included Fisher's exact test, Student's t-test, and logistic regression.

Main Results:

  • SGA infants had lower rates of severe intraventricular hemorrhage but higher rates of bronchopulmonary dysplasia and need for home oxygen therapy.
  • SGA infants born at 24-25 weeks GA showed higher rates of developmental quotient (DQ) < 70.
  • SGA infants born at 26-27 weeks GA had increased prevalence of cerebral palsy (CP) and visual impairment.

Conclusions:

  • Birth at 24-25 weeks GA is a risk factor for low DQ in SGA infants.
  • Birth at 26-27 weeks GA is a risk factor for CP and visual impairment in SGA infants.
  • Further research on nutritional and developmental factors, with longer follow-up, is needed to fully assess neurodevelopmental outcomes.
Abstract

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