Severity of small-for-gestational age and morbidity and mortality among very preterm neonates

DOI: https://doi.org/10.21203/rs.3.rs-1871875/v1

Abstract

Objective: Evaluate the association between small for gestational age (SGA) severity and morbidity and mortality in a contemporary, unselected population of very preterm infants.

Study Design: This secondary analysis of a California statewide database evaluated singleton infants born during 2008-2018 at 24-32 weeks’ gestation, with a birthweight <15th percentile. We analyzed neonatal outcomes in relation to weight for gestational age (WGA) and symmetry of growth restriction.

Results: An increase in WGA by one z-score was associated with decreased major morbidity or mortality risk (aRR 0.73, 95% CI 0.68-0.77) and other adverse outcomes. The association was most pronounced for WGA percentile <3 and did not differ by fetal growth restriction diagnosis. Symmetric growth restriction was not associated with neonatal outcomes after standardizing for gestational age at birth.

Conclusions: Increasing SGA severity, particularly below the 3rd WGA percentile, had a significant impact on neonatal outcomes among very preterm infants.

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