APHM, Hospital University La Conception, Neonatal Unit, Marseille, France.
Regional Health Agency, Provence-Alpes-Côte d'Azur, Marseille, France.
Eur J Pediatr. 2023 May;182(5):2245-2252. doi: 10.1007/s00431-023-04908-2. Epub 2023 Mar 4.
This study aims to determine the association of small for gestational age (SGA) and large for gestational age (LGA) at birth with hospital readmission after postpartum discharge for up to 28 days of delivery. This is a population-based, data-linkage study using the French National Uniform Hospital Discharge Database. "Healthy" singleton term infants born between January 1st, 2017, and November 30th, 2018, in the French South region were included. SGA and LGA were defined as birth weight < 10th and > 90th percentiles, respectively, according to sex and gestational age. A multivariable regression analysis was performed. Among 67,359 included infants, 2441 (3.6%) were readmitted, and 61% of them were hospitalized within 14 days postpartum. Hospitalized infants were more likely to be LGA at birth (10.3% vs. 8.6% in non-hospitalized infants, p < 0.01); the proportion of SGA infants did not differ between both groups. Compared to appropriate birth weight for GA (AGA) infants, LGA infants were more often hospitalized for infectious diseases (57.7% vs. 51.3%, p = 0.05). After regression analysis, LGA infants had a 20% higher odds of being hospitalized than those born AGA (aOR (95%CI) = 1.21 (1.06-1.39)), while aOR (95%CI) for SGA was 1.11 (0.96-1.28).
In contrast to SGA, LGA was associated with hospital readmission during the first month of life. Follow-up protocols that include LGA should be evaluated.
• Newborns are at high risk of hospital readmission during the postpartum period. • However, the influence of appropriateness for gestational age at birth, i.e. being born small for gestational age (SGA) or large for gestational age (LGA), has been little evaluated.
• In contrast to SGA born infants, we found that infants born LGA were at high risk of hospital admission and the main cause was infectious diseases. • This population should be considered at risk of early adverse outcomes and should require attentive medical follow-up after postpartum discharge.
本研究旨在确定出生时体重小于胎龄（SGA）和大于胎龄（LGA）与产后 28 天内出院后住院之间的关系。这是一项基于人群的、数据链接研究，使用法国国家统一住院数据库。纳入 2017 年 1 月 1 日至 2018 年 11 月 30 日在法国南部地区出生的健康单胎足月婴儿。根据性别和胎龄，SGA 和 LGA 分别定义为出生体重 <第 10 百分位数和 >第 90 百分位数。进行多变量回归分析。在纳入的 67359 名婴儿中，有 2441 名（3.6%）被重新入院，其中 61%在产后 14 天内住院。住院婴儿出生时更有可能是 LGA（10.3%比非住院婴儿的 8.6%，p <0.01）；两组之间 SGA 婴儿的比例没有差异。与适合胎龄的体重（AGA）婴儿相比，LGA 婴儿更常因传染病住院（57.7%比 51.3%，p =0.05）。回归分析后，与 AGA 出生婴儿相比，LGA 婴儿住院的可能性高 20%（优势比（95%CI）=1.21（1.06-1.39）），而 SGA 的优势比（95%CI）为 1.11（0.96-1.28）。
与 SGA 相反，LGA 与生命最初一个月的住院有关。应评估包括 LGA 的随访方案。
•新生儿在产后期间有很高的住院风险。
•然而，出生时的胎龄适宜性，即出生时体重小于胎龄（SGA）或大于胎龄（LGA）的影响，尚未得到充分评估。
•与 SGA 出生婴儿相反，我们发现 LGA 出生婴儿住院风险高，主要原因是传染病。
•这一人群应被视为有早期不良结局的风险，并应在产后出院后需要进行仔细的医疗随访。
