We examined the effect of intrauterine growth restriction on mortality and morbidity in the Israel cohort of very low birth weight premature infants.
Methods
The study population included 2764 singleton very low birth weight infants without congenital malformations born from 24 to 31 weeks of gestation during 1995 to 1999. Four hundred six (15%) were born small for gestational age (SGA). The effect of SGA on death, bronchopulmonary dysplasia, and retinopathy of prematurity was assessed using multiple logistic regression analysis.
Results
After adjustment for perinatal risk factors, SGA infants had a 4.52-fold risk for death (95% CI, 3.24-6.33), a 3.42-fold risk for bronchopulmonary dysplasia (95% CI, 2.29-5.13), and a 2.06-fold risk for grade 3 to 4 retinopathy of prematurity (95% CI, 1.15-3.66).
Conclusions
SGA premature infants had an increased risk for death, and major morbidity among survivors was increased.
small for gestational age premature infant mortality morbidity, intrauterine growth restriction very low birth weight outcomes, SGA preterm infant bronchopulmonary dysplasia retinopathy, VLBW infant population based study Israel cohort, fetal growth restriction premature infant survival, Regev Reichman SGA premature infant mortality, intrauterine growth restriction neonatal morbidity logistic regression, small for gestational age 24-31 weeks gestation outcomes, IUGR preterm birth excess mortality population study, very low birth weight singleton neonatal outcomes
PMID 12970630 12970630 DOI 10.1067/S0022-3476(03)00181-1 10.1067/S0022-3476(03)00181-1
Cite this article
Regev, R. H., Lusky, A., Dolfin, T., Litmanovitz, I., Arnon, S., Reichman, B., & Israel Neonatal Network (2003). Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study. The Journal of pediatrics, 143(2), 186-191. https://doi.org/10.1067/S0022-3476(03)00181-1
Regev RH, Lusky A, Dolfin T, Litmanovitz I, Arnon S, Reichman B, et al. Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study. J Pediatr. 2003;143(2):186-191. doi:10.1067/S0022-3476(03)00181-1
Regev, R. H., et al. "Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study." The Journal of pediatrics, vol. 143, no. 2, 2003, pp. 186-191.
Keywords
Bronchopulmonary Dysplasia/epidemiology/mortality, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases/epidemiology/mortality, Infant, Small for Gestational Age, Logistic Models, Retinopathy of Prematurity/epidemiology/mortality
Late preterm infants are at risk for short-term morbidities. We report that late preterm singletons conceived with fertility treatment have increased risk for admission to the neonatal intensive care unit and respiratory support compared with spontaneously conceived infants. Fertility treatment may be a risk factor to consider in managing late preterm infants.
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To study the effect of premature rupture of membranes and oligohydramnios before 20 weeks of gestation (PROM20) on acute respiratory morbidity and on short-term outcome in infants with a gestational age >or=24 weeks. A historic cohort study was performed of all infants born after PROM20 with a gestational age greater-than-or-equal24 weeks between 1990 and 1999. Control infants were matched for year of birth, gestational age, and birth weight. PROM20 infants had an increased acute respiratory morbidity (higher ventilator settings and increased incidence of hypoxemia, hypercapnia, and pulmonary hypertension) and a trend to more air leaks. Although not statistically different, PROM20 infants had more complications (neonatal survival, 68% vs 95%; severe intracranial hemorrhage, 31% vs 6%; chronic lung disease in surviving infants, 46% vs 17%). The relative risk for combined morbidity (death, intracranial hemorrhage, chronic lung disease) was increased (3.0, P =.019) when compared with matched control infants. However, 31% of the surviving PROM20 infants were discharged without apparent morbidity. Expectant treatment in women with PROM20 and present neonatal intensive care has improved the survival of PROM20 infants despite severe initial respiratory failure. However, chronic morbidity still occurred.
PregnancyBirth Defect RiskCongenital AnomaliesPopulation-Based Cohort Study
To investigate the relationship between prematurity and birth defects. In a population-based cohort study, infants with birth defects were ascertained through the Metropolitan Atlanta Congenital Defects Program, a surveillance system with active methods of ascertainment. Gestational age data were obtained from birth certificates of liveborn, singleton infants with and without birth defects born in the 5-county metropolitan Atlanta area. Among 264,392 infants with known gestational ages born between 1989 and 1995, 7738 were identified as having birth defects (2.93%). Premature infants (<37 weeks' gestation) were more than two times as likely to have birth defects than term infants (37-41 weeks) (risk ratio = 2.43; 95% CI 2.30-2.56). This relationship was evident for several categories of birth defects. The rate of birth defects varied by gestational age categories, with the highest risk in the 29- to 32-week gestational age category (risk ratio = 3.37). The risk for birth defects is increased in premature infants. Awareness of this relationship is important for clinicians caring for premature infants. The morbidity and mortality associated with a particular defect may be significantly altered by the presence of prematurity. Further study of this association may provide insight into the etiology of these relatively common problems.