Mortality and morbidity in preterm small-for-gestational-age infants: a population-based study

• Published in: American journal of obstetrics and gynecology Vol. 206; no. 2; pp. 150.e1 - 150.e7
• Main Authors: Grisaru-Granovsky, Sorina, MD, PhD, Reichman, Brian, MB, ChB, Lerner-Geva, Liat, MD, PhD, Boyko, Valentina, MSc, Hammerman, Cathy, MD, Samueloff, Arnon, MD, Schimmel, Michael S., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2012; Elsevier
• Subjects: Biological and medical sciences; Databases, Factual; Diseases of mother, fetus and pregnancy; Female; growth percentile; Gynecology. Andrology. Obstetrics; Humans; Incidence; Infant Mortality; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - mortality; Infant, Small for Gestational Age; Male; Medical sciences; morbidity; mortality; Obstetrics and Gynecology; Pregnancy; Pregnancy. Fetus. Placenta; Severity of Illness Index; small for gestational age; very low birthweight; mortality; growth percentile; small for gestational age; morbidity; very low birthweight; Intrauterine growth retardation; Prognosis; Pregnancy disorders; Gynecology; Mortality; Low birth weight; Epidemiology; Obstetrics; Morbidity; Fetal diseases; Newborn diseases; Prematurity; Public health
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.08.025

Objective We sought to evaluate the impact of severity of growth restriction on mortality and major neonatal morbidity among very-low-birthweight small-for-gestational-age infants. Study Design This was a population-based observational study using data collected by the Israel National Very-Low-Birth-Weight Infant Database 1995 through 2007 including infants 24-31 weeks' gestation, with birthweight (BW) ≤50th percentile without major malformations. Four BW percentile groups were considered: <3rd, 3rd-<10th, 10th-<25th, and a reference group 25th-50th percentile. Univariate and multivariable logistic regression analyses were performed. Results Infants of BW 3rd-<10th percentile were at increased risk for grades 3-4 retinopathy of prematurity (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.54–2.78), bronchopulmonary dysplasia (OR, 2.52; 95% CI, 2.03–3.12), necrotizing enterocolitis (OR, 1.32; 95% CI, 1.04–1.68), and mortality (OR, 2.37; 95% CI, 1.94–2.90). The risk was further increased among infants of BW <3rd percentile. Conclusion Growth restriction severity may serve as a clinical marker of degree of risk for neonatal mortality and various morbidities.