Association between Infant Birth Size Classification and Development of Morbidities in the Neonatal Intensive Care...

Area of Science:

• Neonatalogy
• Perinatal Medicine
• Pediatric Critical Care

Background:

• Morbidities of prematurity (CLD, sROP, sIVH, sNEC) are often studied together, potentially masking distinct risk factors.
• Gestational age (GA) and birth size are critical determinants of neonatal outcomes.

Purpose of the Study:

• To assess the association between birth size metrics (weight, length, head circumference) and specific morbidities in preterm infants.
• To stratify these associations by gestational age (GA) and relevant covariates.

Main Methods:

• Utilized data from the Pediatrix Clinical Data Warehouse (2013-2018) for GAs with >=1% morbidity.
• Classified birth size as small (SGA), appropriate (AGA), or large (LGA) for GA using Olsen curves.
• Employed logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for specific covariates.

Main Results:

• Small for gestational age (SGA) weight increased odds of CLD (OR: 1.6-2.9) and sROP (OR: 1.7-3.6) across most GAs, and sNEC (OR: 1.6-1.8) in at least half.
• Large for gestational age (LGA) weight decreased CLD odds in some GAs and increased sIVH odds only at 27 weeks GA.
• Birth length and head circumference showed similar trends to birth weight.

Conclusions:

• Chronic lung disease (CLD) and severe retinopathy of prematurity (sROP) show consistent associations with GA and birth size.
• Severe necrotizing enterocolitis (sNEC) association with birth size varied across GAs.
• Severe intraventricular hemorrhage (sIVH) demonstrated minimal association with birth size in this cohort.