Neonatal mortality and morbidity in extremely preterm SGA infants: A population based study

Siw Helen Westby Wold ^1*, Kristian Sommerfelt ¹, Hallvard Reigstad ², Arild Rønnestad ³, Sverre Medbø ⁴, Teresa Farstad ⁵, Per Ivar Kaaresen ⁶, Ragnhild Støen ⁷, Katrine Tyborg Leversen ¹, Lorentz Irgens ¹ and Trond Markestad ²

¹ University of Bergen, Norway
² Department of Pediatrics, Haukeland University Hospital, Norway
³ Department of Pediatrics, Rikshospitalet University Hospital, Norway
⁴ Department of Pediatrics, Ullevål University Hospital, Norway
⁵ Department of Pediatrics, Akershus University Hospital, Norway
⁶ Department of Pediatrics, University Hospital of Northern Norway, Norway
⁷ Department of Pediatrics, St. Olav University Hospital, Norway

^* To whom correspondence should be addressed. E-mail: helenwold{at}broadpark.no.

Accepted 27 April 2009

Abstract

Aim: To assess if growth retarded (SGA) extremely preterm infants have excess neonatal mortality and morbidity.

Methods: Cohort study of all infants born alive at 22-27 weeks’ gestational age (GA) in Norway during 1999-2000. Outcomes were compared between those who were SGA, defined as a birth weight less than the fifth percentile for GA and those who had weights at or above the fifth percentile.

Results: Of 365 infants with GA < 28 weeks, 31 (8%) were SGA. Among infants with GA < 28 weeks, only chronic lung disease was associated with SGA status (OR 2.7, 95% CI 1.0 to 7.2). SGA infants with GA 26-27 weeks had excess neonatal mortality (OR 3.8, 95% CI 1.3 to 11), chronic lung disease and significantly higher mean number of days (age) before tolerating full enteral nutrition. SGA infants with GA 22-25 weeks had an excess risk of necrotizing enterocolitis.

Conclusion: Extremely preterm SGA infants had excess neonatal mortality and morbidity in terms of necrotizing enterocolitis and chronic lung disease.