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Morbidity during the first year of life in small for gestational age infants
1Department of Pediatrics, University Hospital, University of Trondheim, Norway.
Insights
Infants born small for gestational age (SGA) face higher risks of hospital admission, primarily for respiratory infections. Maternal smoking during early pregnancy significantly increases this risk for SGA infants.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Infant morbidity and mortality are significant public health concerns.
- Small for gestational age (SGA) infants represent a vulnerable population with potential long-term health implications.
- Understanding risk factors for postneonatal morbidity in SGA infants is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between being small for gestational age (SGA) and postneonatal hospital admissions.
- To identify specific causes of morbidity and risk factors contributing to hospitalizations in SGA infants.
- To explore the impact of maternal factors, such as smoking and previous pregnancy history, on SGA infant morbidity.
Main Methods:
- A comparative study design was employed, analyzing data from 284 small for gestational age (SGA) term infants and 359 non-SGA term infants.
- Infants with congenital malformations were excluded.
- Maternal smoking status and previous pregnancy outcomes were recorded and analyzed in relation to infant hospital admissions.
Main Results:
- Small for gestational age (SGA) infants exhibited a significantly increased risk of hospital admission (OR: 1.7) compared to non-SGA infants, with respiratory tract infections being the primary cause.
- Increased hospitalization risk in SGA infants was strongly associated with maternal smoking during early pregnancy.
- Subgroups of SGA infants, including those born to mothers without a previous SGA child (non-repeaters) and those with symmetric body proportions, showed elevated risks of morbidity.
Conclusions:
- Early pregnancy growth retardation, indicated by being small for gestational age (SGA), can lead to long-term infant morbidity.
- Maternal smoking is a critical modifiable risk factor exacerbating the vulnerability of SGA infants to postneonatal infections and hospitalizations.
- These findings underscore the importance of prenatal care and smoking cessation programs to improve infant health outcomes, particularly for SGA infants.
Abstract:
Postneonatal morbidity during infancy was studied in 284 small for gestational age (SGA) and 359 non-SGA term infants. None of these babies had congenital malformations and they were born to para 1 and para 2 mothers. SGA infants had an increased risk (OR: 1.7, 95% confidence interval: 1.1-2.6) of being admitted to hospital compared with non-SGA infants. The principal cause was respiratory tract infections. Increased hospitalisation among SGA infants was a factor only if the mother was a smoker-that is, smoked cigarettes at the time of conception. Among subgroups of SGA babies, there was an increased risk for infants of non-repeaters (women without a previous SGA child) (OR: 2.4, 95% CI: 1.4-3.8) and for infants with symmetric (OR: 2.0, 95% CI: 1.2-3.3) body proportions compared with non-SGA infants. The results suggest that, beginning in early pregnancy, growth retardation may have long term consequences for subsequent infant morbidity, particularly if the mother is smoker.