1277 Neonatal Morbidity and Mortality in Extremely Preterm Small for Gestational Age Infants. (October 2012)

• Record Type: Journal Article
• Authors: Itabashi, K; Yamakawa, T; Kusuda, S; Fujimura, M
• Is Part Of: Archives of disease in childhood. Volume 97(2012)Supplement 2
• Page Start: A365
• Page End: A365
• Publication Date: 2012-10
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2012-302724.1277
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Neonatal mortality and morbidity in extremely preterm infants (< 28 weeks of gestation) have been extensively studied, but the risk added by intrauterine growth restriction remains controversial. Aim: To assess whether intrauterine growth restricted (small for gestational age, SGA) extremely preterm infants show a further increase in neonatal mortality and morbidity. Methods: The study included 9, 888 singleton extremely preterm infants whose live birth was recorded at the Neonatal Research Network in Japan during 2003–2010. SGA was defined as birth weight at least 2SD below the mean for gestational age. The Risk of mortality and morbidity in the SGA group was evaluated by comparing outcomes for SGA against a non-SGA reference group. Results: Of the study subjects, 1, 215 (12.3%) were SGA. Controlling for gestational age, sex, parity and multiple gestation, SGA infants showed a higher mortality rate during NICU stay compared with reference group infants (odds ratio [OR]: 4.23, p<0.0001). Severe neonatal asphyxia (OR: 1.89, p<0.0001), RDS (OR: 1.33, p<0.0001), chronic lung disease at 36 weeks' postmenstrual age (OR: 2.23, p<0.0001), sepsis (OR: 1.95, p<0.0001), necrotizing enterocolitis (OR: 1.93, p<0.0001), focal intestinal perforation (OR: 1.46, p=0.011) and congenital anomalies (OR: 2.66, p<0.0001) were significantly associated with SGA status. Conclusion: Extremely preterm SGA infants are associated with increased the risk of neonatal mortality and major morbidity. These results are important for obstetric counseling and decision making and treatment of extremely preterm infants.