Outcome of small for gestational age preterm singletons: a population-based cohort study

Tul, Nataša; Lasič, Mateja; Bricelj, Katja; Bregar, Andreja Trojner; Verdenik, Ivan; Lučovnik, Miha; Blickstein, Isaac

doi:10.1515/jpm-2015-0321

Cited by 11 publications

(11 citation statements)

References 11 publications

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“…We identified a 3.1-fold higher risk of BPD among SGA preterm infants compared with non-SGA preterm infants, which was in accordance with previous studies that have reported a 2-6-fold higher risk of BPD for SGA preterm infants (3,22,23). A large proportion of SGA preterm…”

Section: Discussionsupporting

confidence: 91%

Neonatal outcome of small for gestational age infants born at 26–33 weeks’ gestation in Chinese neonatal intensive care units

et al. 2021

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Background: Rate and outcomes of small for gestational age (SGA) infants admitted to Chinese neonatal intensive care units (NICU) has been poorly demonstrated. We aimed to describe the rate and outcomes of SGA preterm infants in Chinese NICU, and to evaluate the association of SGA status with neonatal outcomes in different gestational age (GA) and birth weight percentile groups.Methods: This cohort study included all infants born at 26-33 weeks' gestation and admitted to 25 tertiary Chinese NICUs from April 2015 to May 2018. SGA was defined as a birthweight <10th percentile for GA based on the Chinese neonatal birth weight curve.Results: A total of 24,596 infants were included, and 1,867 (7.6%) infants were SGA. SGA infants had significantly higher rates of death or any major morbidity (29.8% vs. 20.5%), mortality (7.0% vs. 4.1%), bronchopulmonary dysplasia (BPD, 17.6% vs. 9.8%), necrotizing enterocolitis (NEC, 4.8% vs. 3.2%) and sepsis (7.3% vs. 4.8%) than non-SGA infants. SGA status was independently associated with increased risk of death or any major morbidity [adjusted odds ratio: 2.37 (2.08-2.71)] as well as increased risks of death, BPD, ROP, death or BPD, death or ROP, NEC and sepsis. The increased risks of adverse outcomes for SGA infants existed across GA groups. The risks of adverse outcomes were highest among infants with a birthweight <3rd percentile.Conclusions: SGA contributes significantly to adverse neonatal outcomes. Specific attentions are warranted when caring for SGA preterm infants.

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Section: Discussionsupporting

confidence: 91%

Neonatal outcome of small for gestational age infants born at 26–33 weeks’ gestation in Chinese neonatal intensive care units

et al. 2021

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“…Infants born to preeclamptic mothers had significantly greater birth weights and GAs, and the female predominance and SGA proportion were greater in this group than in the control group. SGA status is a common complication of preeclampsia, with a widely ranging incidence of 13.36–52% 11,14,38–40 . In this study, the incidence of SGA in the preeclamptic group was very high, perhaps due to the application of inclusion criteria according to birth weight instead of GA, and thus the enrollment of more SGA infants.…”

Section: Discussionmentioning

confidence: 99%

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Wen

Yang

Chou

et al. 2019

Sci Rep

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Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997–2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.3%) infants born to preeclamptic mothers. The mean (standard deviation) gestational ages were 30.7 (2.5) weeks in the preeclamptic group and 28.6 (2.9) weeks in the control (non-preeclamptic) group. Severe RDS was defined according to the surfactant therapy requirement. The incidence of severe RDS was lower in infants exposed to maternal preeclampsia than in controls [28.9% vs. 44%; odds ratio (OR), 0.52; 95% confidence interval (CI), 0.47–0.57]. However, after adjustment for confounders, the OR for severe RDS development in the preeclampsia group was 1.16 (95% CI, 1.02–1.31). Other factors, such as gestational age, birth weight, female sex, and antenatal receipt of two or more steroid doses were significantly protective against RDS in multivariate regression analysis. This study revealed that maternal preeclampsia slightly increases the risk of severe RDS in VLBW infants.

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“…Many factors influence the outcomes of RDS in infants. Previous studies have reported that gestational age, [ 5 ] use of auxiliary ventilation, [ 6 ] selective cesarean section, severe birth asphyxia, maternal fetal infection, and male sex are closely correlated with full-term neonatal RDS outcomes. [ 7 ] Compared with females of the same gestational age, male preterm infants are at greater risk of developing RDS, and need more initial respiratory and circulatory support.…”

Section: Introductionmentioning

confidence: 99%

Gender-related efficacy of pulmonary surfactant in infants with respiratory distress syndrome

et al. 2018

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Whether gender influences the efficacy of exogenous pulmonary surfactant (PS) for replacement therapy in newborns with respiratory distress syndrome (RDS) has not been well studied yet.Retrospective cohort study design. Data on PS therapy including blood gas, oxygenation function parameters, and therapy results were collected and analyzed from 370 infants diagnosed with RDS in 20 hospitals of the Northwest China Neonatal Collaboration from January 2011 to December 2011.Female infants were more sensitive to PS treatment than males. In multivariate analysis, when adjusted for other variables, an increased initial dose of surfactant significantly reduced mortality risk (OR = 0.98, 95%CI [0.96, 0.99], P = .002). An interaction between gender and initial dose of PS was observed. In male infants, an increased initial dose of surfactant was correlated with reduced mortality risk (OR = 0.97, 95%CI [0.96, 0.99], P = 0.005), while in female infants, we failed to found a relationship between the initial dose of surfactant and the risk of mortality (OR = 0.99, 95%CI [0.96, 1.02], P = .543). Moreover, the effect of surfactant replacement therapy was better for female infants than male infants at initial PS doses <130 mg/kg.Gender influences the efficacy of PS treatment. An increased initial dose of PS should be used in RDS therapy for male infants.

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Outcome of small for gestational age preterm singletons: a population-based cohort study

Abstract: Being SGA further complicates preterm births after 30 weeks of gestation but not earlier. This might suggest that an extended period in the hostile intrauterine environment, or that being born at <30 weeks, is bad enough and is not further aggravated by being SGA.

Cited by 11 publications

References 11 publications

Neonatal outcome of small for gestational age infants born at 26–33 weeks’ gestation in Chinese neonatal intensive care units

Neonatal outcome of small for gestational age infants born at 26–33 weeks’ gestation in Chinese neonatal intensive care units

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Gender-related efficacy of pulmonary surfactant in infants with respiratory distress syndrome

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