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J Pediatr. 2013 Jul;163(1):55-60.e1-3. doi: 10.1016/j.jpeds.2012.12.097. Epub 2013 Feb 14.

Outcomes of small for gestational age infants born at <27 weeks' gestation.

Collaborators (191)

Caplan MS, Laptook AR, Hensman AM, Vohr BR, Burke R, Caskey M, Johnson K, Alksninis B, Andrews D, Angela K, Leach TM, Watson VE, Ventura S, Fanaroff AA, Wilson-Costello DE, Siner BS, Bhola M, Yalcinkaya G, Friedman HG, Schibler K, Donovan EF, Bridges K, Alexander B, Grisby C, Mincey HL, Hessling J, Gratton TL, Steichen JJ, Yolton K, Goldberg RN, Cotten C, Auten KJ, Fisher KA, Grimes S, Gustafson KE, Lohmeyer MB, Carlton DP, Adams-Chapman I, Archer SW, Poindexter BB, Dusick AM, Wilson LD, Hamer F, Herron D, Lytle C, Minnich HM, Poole W, Wallace D, Newman JE, Auman JO, Cunningham M, Huitema CM, Zaterka-Baxter KM, Van Meurs KP, Stevenson DK, Hintz SR, Davis AS, Ball M, Palmquist AW, Proud MS, Bruno E, DeAnda ME, DeBattista AM, Kohn JG, Weiss HE, Frantz ID 3rd, Fiascone JM, MacKinnon BL, Furey A, Nylen E, McGowan EC, Carlo WA, Ambalavanan N, Peralta-Carcelen M, Collins MV, Cosby SS, Biasini FJ, Johnston KC, Nelson KG, Patterson CS, Phillips VA, Whitley S, Finer NN, Vaucher YE, Kaegi D, Rasmussen MR, Arnell K, Demetrio C, Fuller MG, Rich W, West R, Acarregui MJ, Johnson KJ, Eastman DL, Reynolds EM, Duara S, Bauer CR, Everett-Thomas R, Hiriart-Fajardo S, Rigaud A, Calejo M, Eguaras SM, Berkovits M, Garcia A, Pierre H, Stoerger A, Watterberg KL, Lowe JR, Fuller JF, Ohls RK, Lacy CB, Montman R, Brown S, Phelps DL, Myers GJ, Reubens LJ, Burnell E, Hust D, Johnson JB, Jensen RL, Kushner E, Merzbach J, Yost K, Zwetsch L, Johnson LB, Kennedy KA, Tyson JE, Alaniz NI, Evans PW, Green C, Harris BF, Jiminez M, Lis AE, Martin S, McDavid E, Morris BH, Poundstone M, Siddiki S, Simmons MC, Tate PL, Wright SL, Sánchez PJ, Heyne RJ, Salhab WA, Rosenfeld CR, Guzman A, Leps MH, Miller NA, Hensley G, Adams SS, Madden LA, Heyne E, Morgan JS, Boatman CT, Torres LE, Faix RG, Yoder BA, Osborne KA, Spencer C, Weaver-Lewis K, Baker S, Bird K, Burnett J, Steffen M, Zanetti K, O'Shea T, Dillard RG, Washburn LK, Jackson BG, Peters N, Chiu K, Allred DE, Goldstein DJ, Halfond R, Peterson C, Waldrep EL, Welch CD, Morris MW, Hounshell GW, Johnson ME, Goldston LA, Ehrenkranz RA, Jacobs H, Butler CG, Cervone P, Greisman S, Konstantino M, Poulsen J, Taft J, Williams J, Romano E.

Author information

1
Department of Pediatrics, Wayne State University, Detroit, MI, USA.

Abstract

OBJECTIVE:

To determine whether small for gestational age (SGA) infants born at <27 weeks gestational age (GA) are at increased risk for mortality, morbidity, and growth and neurodevelopmental impairment at 18-22 months corrected age.

STUDY DESIGN:

This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-Up Studies. Infants born at <27 weeks GA between January 2006 and July 2008 were included. SGA was defined as birth weight <10th percentile for GA based on Olsen growth curves. Infants with birth weight ≥ 10th percentile for GA were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes, and neurodevelopmental data were compared in SGA and non-SGA infants. Neurodevelopmental impairment was defined as any of the following: cognitive score <70 on the Bayley Scales of Infant Development III, moderate or severe cerebral palsy, bilateral hearing loss (with and without amplification), or blindness (bilateral vision <20/200). Logistic regression analysis was applied to evaluate the associations between SGA status and death or neurodevelopmental impairment.

RESULTS:

The SGA group comprised 385 infants; the non-SGA group, 2586 infants. Compared with mothers of non-SGA infants, mothers of SGA infants were more likely to have a high school education, prenatal care, cesarean delivery, pregnancy-induced hypertension, and antenatal corticosteroid exposure. Compared with non-SGA infants, SGA infants had higher mortality and were more likely to have postnatal growth failure, prolonged mechanical ventilation, and postnatal steroid use. SGA status was associated with increased risk of death or neurodevelopmental impairment (OR, 3.91; 95% CI, 2.91-5.25; P < .001).

CONCLUSION:

SGA status in infants born at <27 weeks GA is associated with an increased likelihood of postnatal steroid use, mortality, growth failure, and neurodevelopmental impairment at 18-22 months corrected age.

PMID:
23415614
PMCID:
PMC3947828
DOI:
10.1016/j.jpeds.2012.12.097
[Indexed for MEDLINE]
Free PMC Article

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