The preterm small-for-gestational age infant: a two-year follow-up study.

Previous investigators have reported unfavorable neurologic and developmental outcome of small-for-gestational age (SGA) infants (birth weight less than 1,500 grams born at term or at less than 30 weeks. of gestation. Since obstetrical considerations for the delivery of a SGA fetus often arise between 30 and 38 weeks, the outcome of these survivors becomes a relevant issue. In 1975 and 1976, twenty-eight of 47 such infants survived and 21 were followed sequentially during the first two years. Their birth weight was 1,220 +/- 195 grams (mean +/- S.D.) and the gestation 33.4 +/- 2 weeks. Each SGA infant was paired with a birth weight-matched appropriate-for-gestation (AGA) infant whose birth weight was 1,195 +/- 190 grams and gestation 29 +/- 2 weeks. The weight, length, and head circumference of the SGA infants attained the tenth percentile by 6 to 8 months and were similar to the AGA group. Quarterly neurologic examinations showed similar findings during the first year in the two groups. At 2 years, two SGA (diplegia) and one AGA (hemiplegia) infants were abnormal. The quarterly Bayley scores of the SGA infants were lower during the first 18 months but at 24 months, the two groups had similar scores. The favorable outcome in preterm SGA infants weighing less than 1,500 grams may serve as useful information in making clinical decisions for the management of mothers with suspected intrauterine growth retardation.