Impact of being small-for-gestational age on survival and long-term outcome of extremely premature infants born at 23–27 weeks' gestation
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Yumi Kono
Abstract
Aim: To evaluate factors affecting survival and long-term outcome of extremely premature infants and to determine whether small for gestational age (SGA) status is an additional risk factor.
Methods: Survival was analyzed in 193 infants born between 23 and 27 weeks of gestational age (GA) and compared between SGA (n=43) and appropriate for gestational age (AGA) infants. Long-term outcome was assessed in 123 infants at six years of chronological age by neurological evaluation and cognitive tests.
Results: The long-term survival rates were 72.1% for SGA and 84.0% for AGA infants. Significant independent factors affecting survival were GA (OR 1.79 for one week advance, 95% CI 1.36–2.34) and SGA (OR 0.42, 95% CI 0.18–0.997) in comparison with AGA. There were no significant differences in rates of cerebral palsy or mental retardation, 12.0% and 24.0% in SGA, 14.3% and 17.3% in AGA, respectively. Fifty-two percent of SGA and 70% of AGA infants had intact long-term outcome. The perinatal factor found to affect the intact long-term outcome was RDS with surfactant therapy (OR 0.17, 95% CI 0.07–0.45).
Conclusion: SGA status as well as short gestation had significant effects on survival. Respiratory complications after birth had a larger detrimental effect on long-term outcome than whether the infant was SGA or AGA.
©2007 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Intrauterine growth restriction and risk for arterial hypertension: a causal relationship?
- Clinical-radiological features of fractures in premature infants – a review
- Scientific and religious controversies about the beginning of human life: the relevance of the ethical concept of the fetus as a patient
- The status of the embryo in Buddhism: opinions on scientific and religious controversies about the beginning of human life
- The calcium binding protein, S100B, is increased in the amniotic fluid of women with intra-amniotic infection/inflammation and preterm labor with intact or ruptured membranes
- Validity of amniotic fluid index in preterm rupture of membranes
- Activity of adenosine deaminase in mothers who have conceived a fetus with central nervous system malformations
- Ductus venosus Doppler measurement during labor
- Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to cardiotocography to predict fetal acidosis in labor / A multi-center, case controlled study
- Comparison of two- and three-dimensional ultrasonography in lung volume measurement of normal fetuses
- MRI and multiplanar 3D ultrasound compared in the prenatal assessment of enlarged posterior fossa
- Monochorionic twins in which at least one fetus has a congenital heart disease with or without twin-twin transfusion syndrome
- Enriched post-discharge formula versus term formula for bone strength in very low birth weight infants: a longitudinal pilot study
- Which information will be given to parents of preterm infants – a comparison of estimates and local data
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Impact of being small-for-gestational age on survival and long-term outcome of extremely premature infants born at 23–27 weeks' gestation
- Gastroschisis: brief early history
- Reply
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