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  1. Home
  2. Association Between Infant Birth Size Classification And Development Of Morbidities In The Neonatal Intensive Care Unit: A Cohort Study.
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  2. Association Between Infant Birth Size Classification And Development Of Morbidities In The Neonatal Intensive Care Unit: A Cohort Study.

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

A Nicole Ferguson1, Marion Granger Howard1, Kevin B Gittner1,2

  • 1School of Data Science and Analytics, Kennesaw State University, Kennesaw, Georgia, USA.

Neonatology
|December 14, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Birth size impacts prematurity morbidities differently. Small for gestational age (SGA) infants face higher risks for chronic lung disease (CLD) and severe retinopathy of prematurity (sROP), while large for gestational age (LGA) infants show varied associations. Severe intraventricular hemorrhage (sIVH) was rarely linked to birth size.

Keywords:
Birth sizeChronic lung disease of prematurityIntraventricular hemorrhageNecrotizing enterocolitisRetinopathy of prematurity

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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.