Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina;
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Pediatrics. 2018 Feb;141(2). doi: 10.1542/peds.2017-2533. Epub 2018 Jan 18.
To identify the relative risks of mortality and morbidities for small for gestational age (SGA) infants in comparison with non-SGA infants born at 22 to 29 weeks' gestation.
Data were collected (2006-2014) on 156 587 infants from 852 US centers participating in the Vermont Oxford Network. We defined SGA as sex-specific birth weight <10th centile for gestational age (GA) in days. Binomial generalized additive models with a thin plate spline term on GA by SGA were used to calculate the adjusted relative risks and 95% confidence intervals for outcomes by GA.
Compared with non-SGA infants, the risk of patent ductus arteriosus decreased for SGA infants in early GA and then increased in later GA. SGA infants were also at increased risks of mortality, respiratory distress syndrome, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. These risks of adverse outcomes, however, were not homogeneous across the GA range. Early-onset sepsis was not different between the 2 groups for the majority of GAs, although severe intraventricular hemorrhage was decreased among SGA infants for only gestational week 24 through week 25.
SGA was associated with additional risks to mortality and morbidities, but the risks differed across the GA range.
比较孕 22 周至 29 周出生的小于胎龄儿（SGA）与非 SGA 儿的死亡率和发病率的相对风险。
数据来自美国 852 个中心的 156587 名婴儿（2006 年至 2014 年），这些婴儿参与了佛蒙特牛津网络。我们将 SGA 定义为性别特异性胎龄日龄的出生体重<第 10 百分位数。采用 SGA 胎龄的二项广义加性模型和薄板样条术语来计算胎龄的调整相对风险和 95%置信区间。
与非 SGA 儿相比，SGA 儿的动脉导管未闭风险在早期胎龄时降低，随后在晚期胎龄时增加。SGA 儿的死亡率、呼吸窘迫综合征、坏死性小肠结肠炎、晚发性败血症、严重早产儿视网膜病变和慢性肺病的风险也增加。然而，这些不良结局的风险在整个胎龄范围内并不均匀。对于大多数胎龄，早发型败血症在两组之间没有差异，尽管只有在 24 周至 25 周的胎龄，SGA 儿的严重脑室出血才减少。
SGA 与死亡率和发病率的其他风险相关，但风险在胎龄范围内有所不同。
