The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants

This study aimed to evaluate the impact of small-for-gestational-age (SGA) on mortality and morbidity in very-low-birth-weight (VLBW) infants. Methods: We conducted a retrospective cohort study on VLBW infants registered at the Premature Baby Foundation of Taiwan between 2007 and 2011. All 21 neonat...

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Main Authors: Li-Yi Tsai, Yi-Ling Chen, Kuo-Inn Tsou, Shu-Chi Mu
Format: Article
Language:English
Published: Elsevier 2015-04-01
Series:Pediatrics and Neonatology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957214001569
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author Li-Yi Tsai
Yi-Ling Chen
Kuo-Inn Tsou
Shu-Chi Mu
author_facet Li-Yi Tsai
Yi-Ling Chen
Kuo-Inn Tsou
Shu-Chi Mu
author_sort Li-Yi Tsai
collection DOAJ
description This study aimed to evaluate the impact of small-for-gestational-age (SGA) on mortality and morbidity in very-low-birth-weight (VLBW) infants. Methods: We conducted a retrospective cohort study on VLBW infants registered at the Premature Baby Foundation of Taiwan between 2007 and 2011. All 21 neonatal departments in Taiwan participated in the data collection, and a total of 4636 VLBW infants were registered during the study period. The SGA group (n = 560) was selected from the database on the basis of birth weight below the 10th percentile for gestational age, whereas the appropriate-weight-for-gestational-age (AGA) group (n = 1120) included infants randomly selected via incidence density sampling with a 2:1 match for each SGA case. The association of SGA with individual outcome variables including mortality, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity (ROP), intraventricular hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia (BPD) was evaluated after adjustment for potential confounders. Results: The SGA group was associated with increased risks of mortality [odds ratio (OR) 1.89; 95% confidence interval (CI) 1.39‒2.58], severe ROP (OR 1.56; 95% CI 1.13–2.14), and BPD (OR 2.08; 95% CI 1.58–2.75) compared to the AGA group. Further subgroup analysis showed that SGA had significant effects on mortality in the VLBW infants with a gestational age of 24–29 weeks, as well as on BPD in those with a gestational age of 27–32 weeks. By contrast, the association of SGA with severe ROP was only significant in the VLBW infants with a gestational age of 27–29 weeks. Conclusion: Our data provide evidence that SGA may be associated with increased risks of neonatal mortality, ROP, and BPD in VLBW infants.
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spelling doaj.art-9d8c8732afe640b3bef79ec43d86b4782022-12-22T01:14:26ZengElsevierPediatrics and Neonatology1875-95722015-04-0156210110710.1016/j.pedneo.2014.07.007The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight InfantsLi-Yi Tsai0Yi-Ling Chen1Kuo-Inn Tsou2Shu-Chi Mu3Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanCollege of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanDepartment of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanThis study aimed to evaluate the impact of small-for-gestational-age (SGA) on mortality and morbidity in very-low-birth-weight (VLBW) infants. Methods: We conducted a retrospective cohort study on VLBW infants registered at the Premature Baby Foundation of Taiwan between 2007 and 2011. All 21 neonatal departments in Taiwan participated in the data collection, and a total of 4636 VLBW infants were registered during the study period. The SGA group (n = 560) was selected from the database on the basis of birth weight below the 10th percentile for gestational age, whereas the appropriate-weight-for-gestational-age (AGA) group (n = 1120) included infants randomly selected via incidence density sampling with a 2:1 match for each SGA case. The association of SGA with individual outcome variables including mortality, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity (ROP), intraventricular hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia (BPD) was evaluated after adjustment for potential confounders. Results: The SGA group was associated with increased risks of mortality [odds ratio (OR) 1.89; 95% confidence interval (CI) 1.39‒2.58], severe ROP (OR 1.56; 95% CI 1.13–2.14), and BPD (OR 2.08; 95% CI 1.58–2.75) compared to the AGA group. Further subgroup analysis showed that SGA had significant effects on mortality in the VLBW infants with a gestational age of 24–29 weeks, as well as on BPD in those with a gestational age of 27–32 weeks. By contrast, the association of SGA with severe ROP was only significant in the VLBW infants with a gestational age of 27–29 weeks. Conclusion: Our data provide evidence that SGA may be associated with increased risks of neonatal mortality, ROP, and BPD in VLBW infants.http://www.sciencedirect.com/science/article/pii/S1875957214001569neonatal outcomeprematuritysmall-for-gestational-age
spellingShingle Li-Yi Tsai
Yi-Ling Chen
Kuo-Inn Tsou
Shu-Chi Mu
The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
Pediatrics and Neonatology
neonatal outcome
prematurity
small-for-gestational-age
title The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
title_full The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
title_fullStr The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
title_full_unstemmed The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
title_short The Impact of Small-for-gestational-age on Neonatal Outcome Among Very-low-birth-weight Infants
title_sort impact of small for gestational age on neonatal outcome among very low birth weight infants
topic neonatal outcome
prematurity
small-for-gestational-age
url http://www.sciencedirect.com/science/article/pii/S1875957214001569
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