Severity of small-for-gestational-age and morbidity and mortality among very preterm neonates

Kathleen C Minor; Katherine Bianco; Lillian Sie; Maurice L Druzin; Henry C Lee; Stephanie A Leonard

doi:10.1038/s41372-022-01544-w

Severity of small-for-gestational-age and morbidity and mortality among very preterm neonates

J Perinatol. 2023 Apr;43(4):437-444. doi: 10.1038/s41372-022-01544-w. Epub 2022 Oct 27.

Authors

Kathleen C Minor¹, Katherine Bianco², Lillian Sie^{3

4}, Maurice L Druzin², Henry C Lee^{3

4}, Stephanie A Leonard²

Affiliations

¹ Division of Maternal-Fetal Medicine & Obstetrics, Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA, US. minork@stanford.edu.
² Division of Maternal-Fetal Medicine & Obstetrics, Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA, US.
³ Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, US.
⁴ California Perinatal Quality Care Collaborative, Stanford, CA, US.

PMID: 36302849
DOI: 10.1038/s41372-022-01544-w

Abstract

Objective: Evaluate the association between small for gestational age (SGA) severity and morbidity and mortality in a contemporary, population of very preterm infants.

Study design: This secondary analysis of a California statewide database evaluated singleton infants born during 2008-2018 at 24-32 weeks' gestation, with a birthweight <15th percentile. We analyzed neonatal outcomes in relation to weight for gestational age (WGA) and symmetry of growth restriction.

Results: An increase in WGA by one z-score was associated with decreased major morbidity or mortality risk (aRR 0.73, 95% CI 0.68-0.77) and other adverse outcomes. The association was maintained across gestational ages and did not differ by fetal growth restriction diagnosis. Symmetric growth restriction was not associated with neonatal outcomes after standardizing for gestational age at birth.

Conclusions: Increasing SGA severity had a significant impact on neonatal outcomes among very preterm infants.

MeSH terms

Birth Weight
Female
Fetal Growth Retardation
Gestational Age
Humans
Infant, Extremely Premature
Infant, Newborn
Infant, Newborn, Diseases*
Infant, Premature, Diseases*
Infant, Small for Gestational Age