Tyson J E, Kennedy K, Broyles S, Rosenfeld C R
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063, USA.
Pediatrics. 1995 Apr;95(4):534-8.
Small for gestational age (SGA) neonates have been considered to have accelerated pulmonary maturation and thus a lower risk for respiratory distress syndrome (RDS) than appropriate for gestational age (AGA) neonates. This, however, has not been thoroughly examined. Therefore, we compared SGA infants with AGA infants of the same gestational age (GA) with respect to risk of RDS, respiratory failure, or death.
An indigent population born in a large county hospital.
Multivariate analyses were performed controlling for GA alone or for GA, race, sex, and congenital anomalies. Because the proper method to identify SGA infants is unclear, we performed separate analyses using different GA estimates (obstetric or pediatric) and intrauterine growth grids (hospital-specific grids or grids for a healthy, geographically-defined population).
SGA infants did not fare better than AGA infants in any analysis. SGA infants had significantly increased risk in some analyses of RDS and in almost all analyses of respiratory failure or death. The risk associated with being SGA was generally comparable to that associated with male sex or White race.
The concept that intrauterine growth retardation accelerates lung maturation and improves outcome is not supported in comparisons of SGA and AGA infants of the same GA, sex, and race. This widely accepted concept deserves critical re-evaluation.
小于胎龄（SGA）新生儿被认为肺成熟加速，因此与适于胎龄（AGA）新生儿相比，呼吸窘迫综合征（RDS）风险更低。然而，这一点尚未得到充分研究。因此，我们比较了相同胎龄（GA）的SGA婴儿和AGA婴儿在RDS、呼吸衰竭或死亡风险方面的差异。
在一家大型县医院出生的贫困人群。
进行多变量分析，单独控制胎龄或同时控制胎龄、种族、性别和先天性异常。由于确定SGA婴儿的正确方法尚不清楚，我们使用不同的胎龄估计值（产科或儿科）和子宫内生长网格（医院特定网格或健康、地理定义人群的网格）进行了单独分析。
在任何分析中，SGA婴儿的情况都不比AGA婴儿好。在一些RDS分析以及几乎所有呼吸衰竭或死亡分析中，SGA婴儿的风险显著增加。与SGA相关的风险通常与男性或白人种族相关的风险相当。
在相同GA、性别和种族的SGA婴儿与AGA婴儿的比较中，宫内生长迟缓加速肺成熟并改善结局这一概念未得到支持。这一被广泛接受的概念值得进行批判性重新评估。
