Ho J
Perak College of Medicine, Greentown, Ipoh, Malaysia.
Singapore Med J. 2001 Aug;42(8):355-9.
To compare the neonatal course of small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants 1500 g or less birthweight.
A total of 116 infants SGA infants 32 weeks or less were matched with 116 AGA infants of the same gestation, ethnic group, sex and where possible inborn or outborn status.
Significantly more SGA infants had a 1-minute Apgar scores of 3 or less, odds ratio (OR) 2.54 (95% Confidence Interval (CI) 1.25, 5.20) and a Critical Risk Index in Babies (CRIB) score > 5, OR 2.09 (95% CI 1.07, 4.09). They were significantly more likely to have hypotension, 35.5 versus 22.3%, OR 1.90 (95% CI 1.01, 3.59). There was no difference in the frequency of respiratory distress syndrome, mechanical ventilation, infection or rate of congenital malformation. Mortality before hospital discharge was significantly greater for the SGA infant (52.6 versus 28.4%, OR 2.79 (95% CI 1.56, 5.02)). This difference remained significant after exclusion of congenital abnormalities. Survivors had a longer mean duration of stay, (54.4 versus 41.2 days, p < 0.001).
The higher mortality seen in SGA infants appears to be due to a poorer condition at birth. There is no evidence that SGA infants have more mature lungs so antenatal corticosteroids should not be withheld on these grounds.
比较出生体重1500克及以下的小于胎龄（SGA）早产儿和适于胎龄（AGA）早产儿的新生儿病程。
将116例孕32周及以下的SGA婴儿与116例相同孕周、种族、性别且尽可能在出生地点（院内或院外）相同的AGA婴儿进行匹配。
SGA婴儿1分钟阿氏评分≤3分的比例显著更高，比值比（OR）为2.54（95%置信区间（CI）为1.25, 5.20），婴儿危急风险指数（CRIB）评分>5分的比例也显著更高，OR为2.09（95%CI为1.07, 4.09）。他们发生低血压的可能性显著更高，分别为35.5%和22.3%，OR为1.90（95%CI为1.01, 3.59）。呼吸窘迫综合征、机械通气、感染或先天性畸形发生率无差异。SGA婴儿出院前死亡率显著更高（52.6%对28.4%，OR为2.79（95%CI为1.56, 5.02））。排除先天性异常后，这种差异仍然显著。存活者的平均住院时间更长（54.4天对41.2天，p<0.001）。
SGA婴儿较高的死亡率似乎是由于出生时状况较差。没有证据表明SGA婴儿肺部更成熟，因此不应因此而不给予产前糖皮质激素。
