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Mortality and morbidity in infants with intrauterine growth retardation
Insights
Infants small for gestational age (SGA) and appropriate for gestational age (AGA) have similar overall risks for adverse outcomes. However, AGA infants face higher neonatal death risks, while SGA infants experience more issues during the first year.
Area of Science:
- Neonatal Health
- Pediatric Outcomes
- Public Health
Background:
- Low birth weight infants are categorized as either small for gestational age (SGA) or appropriate for gestational age (AGA).
- Understanding differential risks associated with SGA and AGA infants is crucial for targeted interventions.
Purpose of the Study:
- To analyze and compare the adverse outcomes at one year of age for low birth weight infants categorized as SGA versus AGA.
- To determine if the nature of risks differs between SGA and AGA infants despite similar overall adverse outcome rates.
Main Methods:
- Analysis of birth and one-year follow-up data from a broad population of urban and rural US births.
- Infants in the lowest quartile of weight for gestational age were classified as SGA; others were classified as AGA.
- Outcomes assessed included mortality before one year and handicaps at one year of age.
Main Results:
- Both SGA and AGA infants, despite being low birth weight, showed similar overall proportions of mortality or handicaps by one year.
- Appropriate-for-gestational age infants demonstrated a greater risk of neonatal death.
- Small-for-gestational age infants exhibited a higher risk for problems manifesting during the first year of life or identified at the one-year assessment.
Conclusions:
- While overall adverse outcome risks are comparable, the timing and nature of these risks differ significantly between SGA and AGA low birth weight infants.
- AGA infants are more vulnerable neonatally, whereas SGA infants face prolonged risks into infancy.
- Findings are generalizable due to the use of population-based data.
Abstract:
This report is based on an analysis of the experience with all births in several urban and rural areas of the United States. All infants whose birth weight was in the lowest quartile for their week of gestation were designated as small for gestational age regardless of their birth weight or length of gestation; other infants were considered appropriate for gestation age. We interpret the data to indicate that appropriate-for-gestational age and small-for-gestational age infants, all of low birth weight, differ in the nature of their risk for adverse outcome as determined by an assessment at one year of age, although both are at approximately equal risk of adverse outcome overall. In each weight group, the total proportion of infants who either died before one year of age or were handicapped at one year of age was similar for small-for-gestational age and appropriate-for-gestational age infants, but appropriate-for-gestational age infants were at greater risk of neonatal death and small-for-gestational age infants were at greater risk of problems manifested during the first year of life or at one year of age. As the findings are based on data obtained from entire populations (rather than from infants born in particular hospitals), they are likely to be generalizable.