Outcome of small-for-gestational age and appropriate-for-gestational age infants born before 27 weeks of gestation

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C Bardin1, P Zelkowitz, A Papageorgiou

  • 1Department of Neonatology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

Pediatrics
|August 1, 1997
PubMed

Insights

Infants born small-for-gestational age before 27 weeks face increased risks of serious health issues. These include patent ductus arteriosus, chronic lung disease, and retinopathy of prematurity, impacting long-term outcomes.

Area of Science:

  • Neonatalogy
  • Perinatology
  • Pediatric Critical Care

Background:

  • Premature birth poses significant health challenges.
  • Infants born small-for-gestational age (SGA) may experience distinct morbidities.
  • Understanding risks for extremely premature infants is crucial for improved care.

Purpose of the Study:

  • To evaluate the long-term health consequences for infants born small-for-gestational age (SGA) at extremely low gestational ages.
  • To compare morbidities between SGA and appropriate-for-gestational age (AGA) infants born before 27 weeks.
  • To identify specific risks associated with SGA status in this vulnerable population.

Main Methods:

  • Retrospective cohort study comparing SGA and AGA infants born between 24 and 26 6/7 weeks gestation.
  • Data collected from 191 neonatal intensive care unit admissions (1983-1992).
  • Analysis included demographics, delivery factors, mortality, and neonatal morbidities (e.g., PDA, CLD, ROP).

Main Results:

  • SGA infants (21%) showed similar rates of respiratory distress syndrome but higher rates of failed indomethacin treatment for PDA (54% vs 32%).
  • SGA infants had a significantly increased risk for chronic lung disease (CLD) (65% vs 32%) and severe retinopathy of prematurity (ROP) (65% vs 12%).
  • Prolonged need for oxygen supplementation and ventilatory support was observed in SGA infants.

Conclusions:

  • Being small-for-gestational age (SGA) before 27 weeks gestation confers substantial additional risks for severe neonatal morbidities.
  • Key risks include patent ductus arteriosus (PDA) ligation, chronic lung disease (CLD), and severe retinopathy of prematurity (ROP).
  • These findings highlight the need for targeted interventions and monitoring for extremely preterm SGA infants.
Abstract

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