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Author Notes:

Corresponding Author: Lilia C. De Jesus, MD, Department of Pediatrics, Wayne State University, Detroit, MI. ldejesus@med.wayne.edu, Tel. 313-7455638, Fax. 313-7455867.

We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study.

Data collected at participating sites of the NICHD Neonatal Research Network were transmitted to RTI International, the data coordinating center for the network; which stored, managed and analyzed the data for this study.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors declare no conflicts of interest.

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Research Funding:

See publication for full funding statement.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • BIRTH-WEIGHT INFANTS
  • NEURODEVELOPMENTAL OUTCOMES
  • GROWTH RESTRICTION
  • FETAL
  • MORTALITY
  • DEXAMETHASONE
  • HYPERTENSION
  • ASSOCIATION
  • MORBIDITY
  • SURVIVAL

Outcomes of Small for Gestational Age Infants Born at < 27 Weeks' Gestation

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Journal Title:

Journal of Pediatrics

Volume:

Volume 163, Number 1

Publisher:

, Pages 55-U436

Type of Work:

Article | Post-print: After Peer Review

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.

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© 2013 Mosby Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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