Neonatal mortality and morbidity in extremely preterm small for gestational age infants: a population based study.
OBJECTIVE
To assess if growth restricted (small for gestational age, SGA) extremely preterm infants have excess neonatal mortality and morbidity.


METHODS
This was a cohort study of all infants born alive at 22-27 weeks' post menstrual age in Norway during 1999-2000. Outcomes were compared between those who were SGA, defined as a birth weight less than the fifth percentile for post menstrual age, and those who had weights at or above the fifth percentile.


RESULTS
Of 365 infants with a post menstrual age of <28 weeks, 31 (8%) were SGA. Among infants with a post menstrual age of <28 weeks, only chronic lung disease was associated with SGA status (OR 2.7, 95% CI 1.0 to 7.2). SGA infants with a post menstrual age of 26-27 weeks had excess neonatal mortality (OR 3.8, 95% CI 1.3 to 11), chronic lung disease and a significantly higher mean number of days (age) before tolerating full enteral nutrition. SGA infants with a post menstrual age of 22-25 weeks had an excess risk of necrotising enterocolitis.


CONCLUSIONS
Extremely preterm SGA infants had excess neonatal mortality and morbidity in terms of necrotising enterocolitis and chronic lung disease.
Westby Wold
S H
SH
Department of Clinical Medicine, University of Bergen, Bergen, Norway. helenwold@broadpark.no
Sommerfelt
K
K
Reigstad
H
H
Rønnestad
A
A
Medbø
S
S
Farstad
T
T
Kaaresen
P I
PI
Støen
R
R
Leversen
K T
KT
Irgens
L M
LM
Markestad
T
T
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality; D007236:Infant, Small for Gestational Age; D015931:Intensive Care, Neonatal / Q000592:standards*; D008171:Lung Diseases / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D015997:Neonatal Screening; D009664:Norway / Q000453:epidemiology; D011296:Prenatal Diagnosis; D012307:Risk Factors