Giapros Vasileios, Drougia Aikaterini, Krallis Nikolaos, Theocharis Paraskevi, Andronikou Styliani
Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece.
J Matern Fetal Neonatal Med. 2012 Feb;25(2):153-7. doi: 10.3109/14767058.2011.565837. Epub 2011 Apr 4.
Small-for-gestational age (SGA) neonates born prematurely may be at higher risk for adverse effects during the early postnatal period than premature neonates born appropriate for gestational age (AGA).This study aims to study comparatively morbidity and mortality in SGA and AGA neonates born with low gestational age (GA).
The study population included all preterm infants born alive with GA 24-31 weeks in Northwestern Greece during a 9-year period and hospitalized in the regional neonatal intensive care unit (NICU). The association of SGA status with neonatal death, and with chronic lung disease (CLD), intraventricular haemorrhage (IVH), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), and sepsis was assessed, using multiple logistic regression analysis.
Of 210 infants without congenital anomalies born at GA 24-31 weeks, 51 were SGA and 159 were AGA. CLD was more common in SGA than in AGA neonates (57.1% vs 29.3%, p < 0.05), but no differences were found in the rates of IVH, NEC, ROP, RDS, and sepsis. The mortality rate in the SGA group was 33.3% vs 17% in the AGA group (p < 0.01), and in the subgroups 28-31 weeks 24.1% vs 6.3%, respectively, (p < 0.01). In logistic regression analysis, SGA status was strongly associated with increased mortality and CLD, independent of confounding factors [odd ratios and confidence intervals: 3.4 (CI: 1.8-10.6) p = 0.03 and 3.9 (CI: 1.7-11.5) p < 0.01, respectively.
SGA neonates with GA 24-31 weeks were at increased risk of development of CLD and of neonatal death compared with AGA neonates of the same GA.
与适于胎龄（AGA）的早产新生儿相比，早产的小于胎龄（SGA）新生儿在出生后早期发生不良反应的风险可能更高。本研究旨在比较低胎龄（GA）出生的SGA和AGA新生儿的发病率和死亡率。
研究人群包括希腊西北部9年间出生时胎龄为24 - 31周且存活并入住当地新生儿重症监护病房（NICU）的所有早产儿。使用多因素逻辑回归分析评估SGA状态与新生儿死亡、慢性肺病（CLD）、脑室内出血（IVH）、早产儿视网膜病变（ROP）、坏死性小肠结肠炎（NEC）、呼吸窘迫综合征（RDS）、动脉导管未闭（PDA）和败血症之间的关联。
在24 - 31周出生且无先天性异常的210例婴儿中，51例为SGA，159例为AGA。CLD在SGA新生儿中比AGA新生儿更常见（57.1%对29.3%，p < 0.05），但在IVH、NEC、ROP、RDS和败血症的发生率上未发现差异。SGA组的死亡率为33.3%，AGA组为17%（p < 0.01），在28 - 31周的亚组中分别为24.1%对6.3%（p < 0.01）。在逻辑回归分析中，SGA状态与死亡率增加和CLD密切相关，独立于混杂因素[比值比和置信区间：分别为3.4（CI：1.8 - 10.6）p = 0.03和3.9（CI：1.7 - 11.5）p < 0.01]。
与相同胎龄的AGA新生儿相比，胎龄为24 - 31周的SGA新生儿发生CLD和新生儿死亡的风险增加。
