Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study☆

Abstract 

Objective We examined the effect of intrauterine growth restriction on mortality and morbidity in the Israel cohort of very low birth weight premature infants.

Methods The study population included 2764 singleton very low birth weight infants without congenital malformations born from 24 to 31 weeks of gestation during 1995 to 1999. Four hundred six (15%) were born small for gestational age (SGA). The effect of SGA on death, bronchopulmonary dysplasia, and retinopathy of prematurity was assessed using multiple logistic regression analysis.

Results After adjustment for perinatal risk factors, SGA infants had a 4.52-fold risk for death (95% CI, 3.24-6.33), a 3.42-fold risk for bronchopulmonary dysplasia (95% CI, 2.29-5.13), and a 2.06-fold risk for grade 3 to 4 retinopathy of prematurity (95% CI, 1.15-3.66).

Conclusions SGA premature infants had an increased risk for death, and major morbidity among survivors was increased.

Abbreviations:  AGA, Appropriate for gestational age, BPD, Bronchopulmonary dysplasia, IUGR, Intrauterine growth restriction, IVH, Intraventricular hemorrhage, NEC, Necrotizing enterocolitis, PVL, Periventricular leukomalacia, RDS, Respiratory distress syndrome, ROP, Retinopathy of prematurity, SGA, Small for gestational age, VLBW, Very low birth weight