The impact of small-for-gestational-age on neonatal outcome among very-low-birth-weight infants

Li-Yi Tsai; Yi-Ling Chen; Kuo-Inn Tsou; Shu-Chi Mu; Taiwan Premature Infant Developmental Collaborative Study Group

doi:10.1016/j.pedneo.2014.07.007

The impact of small-for-gestational-age on neonatal outcome among very-low-birth-weight infants

Pediatr Neonatol. 2015 Apr;56(2):101-7. doi: 10.1016/j.pedneo.2014.07.007. Epub 2014 Oct 28.

Authors

Li-Yi Tsai¹, Yi-Ling Chen², Kuo-Inn Tsou³, Shu-Chi Mu⁴; Taiwan Premature Infant Developmental Collaborative Study Group

Collaborators

Taiwan Premature Infant Developmental Collaborative Study Group:
Wu-Shiun Hsieh, Chyong-Hsin Hsu, Ray-In Lin, Chang Gung, Hung-Chih Lin, Chao-Ching Huang, Kai-Sheng Hsieh

Affiliations

¹ Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
² Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
³ College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Pediatrics, Catholic Tien Hospital, Taipei, Taiwan.
⁴ Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: musc1006@yahoo.com.tw.

PMID: 25440777
DOI: 10.1016/j.pedneo.2014.07.007

Abstract

Background: This study aimed to evaluate the impact of small-for-gestational-age (SGA) on mortality and morbidity in very-low-birth-weight (VLBW) infants.

Methods: We conducted a retrospective cohort study on VLBW infants registered at the Premature Baby Foundation of Taiwan between 2007 and 2011. All 21 neonatal departments in Taiwan participated in the data collection, and a total of 4636 VLBW infants were registered during the study period. The SGA group (n = 560) was selected from the database on the basis of birth weight below the 10(th) percentile for gestational age, whereas the appropriate-weight-for-gestational-age (AGA) group (n = 1120) included infants randomly selected via incidence density sampling with a 2:1 match for each SGA case. The association of SGA with individual outcome variables including mortality, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity (ROP), intraventricular hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia (BPD) was evaluated after adjustment for potential confounders.

Results: The SGA group was associated with increased risks of mortality [odds ratio (OR) 1.89; 95% confidence interval (CI) 1.39‒2.58], severe ROP (OR 1.56; 95% CI 1.13-2.14), and BPD (OR 2.08; 95% CI 1.58-2.75) compared to the AGA group. Further subgroup analysis showed that SGA had significant effects on mortality in the VLBW infants with a gestational age of 24-29 weeks, as well as on BPD in those with a gestational age of 27-32 weeks. By contrast, the association of SGA with severe ROP was only significant in the VLBW infants with a gestational age of 27-29 weeks.

Conclusion: Our data provide evidence that SGA may be associated with increased risks of neonatal mortality, ROP, and BPD in VLBW infants.

Keywords: neonatal outcome; prematurity; small-for-gestational-age.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Weight
Female
Humans
Incidence
Infant
Infant Mortality
Infant, Newborn
Infant, Newborn, Diseases / epidemiology*
Infant, Premature
Infant, Small for Gestational Age
Infant, Very Low Birth Weight
Male
Morbidity
Retrospective Studies
Risk Factors
Taiwan / epidemiology