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Comparison of Cardiac Function Among Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA)
Priyanka Gupta1, Sai Kiran Deshabhotla1, Venkateshwarlu Vardhelli1
1Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India.
Insights
Cardiac function in preterm small for gestational age (SGA) and appropriate for gestational age (AGA) neonates is similar in the first 72 hours. Perfusion index showed dynamic changes, reflecting normal physiological transition in both groups.
Area of Science:
- Neonatal Cardiology
- Perinatal Physiology
- Pediatric Echocardiography
Background:
- Small for gestational age (SGA) neonates exhibit altered cardiovascular adaptation.
- Limited data exists on cardiac function in preterm SGA neonates during early transition.
- Understanding cardiac function in preterm SGA neonates is crucial for optimizing care.
Purpose of the Study:
- To compare cardiac function in preterm SGA versus appropriate for gestational age (AGA) neonates within the first 72 hours of life.
- To investigate differences in left ventricular output and other echocardiographic parameters.
- To assess the transitional cardiovascular changes in these distinct neonatal groups.
Main Methods:
- Prospective study at an Indian tertiary care neonatal center.
- Echocardiography used to assess cardiac function at three time points within 72 hours.
- Comparison between hemodynamically stable preterm SGA (28 6/7–34 6/7 weeks) and AGA neonates.
Main Results:
- No significant difference in left ventricular output between SGA and AGA neonates.
- Systolic and diastolic parameters were comparable across time points.
- Perfusion index showed time-dependent changes, indicating physiological transition, while other secondary parameters lacked sustained significance after correction.
Conclusions:
- Hemodynamically stable preterm SGA and AGA neonates demonstrate comparable cardiac function in early life.
- Left ventricular output and key systolic/diastolic parameters are similar between groups.
- Observed changes in perfusion index reflect normal physiological transition rather than group-specific dysfunction.
Objective:
Small for gestational age (SGA) neonates are known to have altered cardiovascular adaptation; however, data on cardiac function during the early transitional period in preterm neonates remain limited. This study aimed to compare cardiac function during the first 72 h of life between preterm SGA and appropriate for gestational age (AGA) neonates.
Methods:
In this prospective study done at an Indian tertiary care neonatal centre, cardiac function by echocardiography was compared at three predefined time points during the first 72 h of life between hemodynamically stable preterm (28 0/6-34 6/7) SGA and AGA neonates.
Results:
A total of 57 SGA and 91 AGA neonates were studied. On descriptive analysis, systolic and diastolic filling parameters were comparable between SGA and AGA neonates across time points. On repeated measures analysis adjusted for gestational age, sex, maternal factors, and antenatal doppler findings, there was no significant group difference in the left ventricular output (primary outcome variable). Among the secondary outcome variables, ejection fraction and isovolumic relaxation time showed significant differences on initial analysis; however, these did not remain significant after Bonferroni correction for multiple comparisons. Perfusion index demonstrated a significant time effect that persisted after Bonferroni correction, indicating dynamic changes during the early transitional period.
Conclusion:
Hemodynamically stable SGA and AGA neonates had comparable left ventricular output and other systolic and diastolic functional parameters, except for a time-related change in perfusion index, likely reflecting physiological transition.
