title: Outcomes of small for gestational age infants born at <27 weeks' gestation.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors: Lilia C
authors: LC
authors: De Jesus
authors: Athina
authors: A
authors: Pappas
authors: Seetha
authors: S
authors: Shankaran
authors: Lei
authors: L
authors: Li
authors: Abhik
authors: A
authors: Das
authors: Edward F
authors: EF
authors: Bell
authors: Barbara J
authors: BJ
authors: Stoll
authors: Abbot R
authors: AR
authors: Laptook
authors: Michele C
authors: MC
authors: Walsh
authors: Ellen C
authors: EC
authors: Hale
authors: Nancy S
authors: NS
authors: Newman
authors: Rebecca
authors: R
authors: Bara
authors: Rosemary D
authors: RD
authors: Higgins
mesh_terms: D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D007236:Infant, Small for Gestational Age; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors