Intrauterine growth restriction in very low birth weight newborns: Neonatal outcome

Bernstein, Joel; Horbar, Jeffrey D.; Badger, Gary J.; Golan, Agi; Ohisson, Arne; Network, Vermont Oxford Neonatal

doi:10.1016/s0002-9378(97)80143-3

Cited by 5 publications

(2 citation statements)

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“…It is generally believed that compromised vascular supply to the gastrointestinal tract in utero increases the incidence of NEC in SGA infants. NEC was found to be increased 19 and unchanged 7,16 by various investigators. When the group of patients < 32 weeks' gestation was examined separately we could indeed demonstrate a trend toward increased incidence of this disease entity, although larger numbers are needed to get a definitive answer to this question.…”

Section: Resultsmentioning

confidence: 95%

Neonatal Outcome in Growth-Restricted Versus Appropriately Grown Preterm Infants

Simchen¹,

Beiner²,

Strauss-Liviathan³

et al. 2000

Am J Perinatol

140

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The objective of this paper is to examine whether growth-restricted preterm infants have a different neonatal outcome than appropriately grown preterm infants. All consecutive, singleton preterm deliveries between 27-35 weeks' gestation were included over a 4-year period. Infants with congenital anomalies and infants of diabetic mothers were excluded. Infants were categorized as small-for-gestational-age (SGA) when birth weight was at or below the 10th percentile, and appropriate-for-gestational-age (AGA) when between the 11th and 90th percentiles. Outcome variables included: neonatal death, respiratory distress syndrome (RDS), sepsis, intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). Neonatal morbidity and mortality were examined by univariate and stepwise multivariate logistic regression analyses. Factors controlled for during the analysis included: maternal age; gestational age; mode of delivery; presence of preeclampsia, HELLP syndrome, prolonged premature rupture of membranes (PROM), placental abruption, placenta previa, prenatal steroid exposure, infant gender, and low Apgar score. Seventy-six infants were included in the SGA group and 209 in the AGA group. SGA infants had a higher mortality rate (p = 0.003). They also had more culture-proven sepsis episodes (p = 0.001). No differences were found with respect to the other outcomes. The results were similar when analyzed separately for the group of infants born at or below 32 weeks' gestation. Growth-restricted preterm infants were found to have both higher mortality and infection rates compared with AGA preterm infants. Growth restriction in the preterm neonate was not found to protect against other neonatal outcomes associated with prematurity. When considering elective preterm delivery for this high-risk group of pregnancies, the increased risks in the neonatal period should be taken into account.

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Section: Resultsmentioning

confidence: 95%

Neonatal Outcome in Growth-Restricted Versus Appropriately Grown Preterm Infants

Simchen¹,

Beiner²,

Strauss-Liviathan³

et al. 2000

Am J Perinatol

140

View full text Add to dashboard Cite

show abstract

“…It affects 7–10% of all pregnancies [ 1 ] and is considered a major contributor to perinatal morbidity and mortality, responsible for about 20–50% of perinatal deaths. It is also associated with worse short and long-term outcomes as increased prevalence of intrapartum distress, neonatal complications [ 2 ], suboptimal neurodevelopment [ 3 , 4 ] and cardiovascular disease [ 5 , 6 ]. Currently, there is no effective nutritional therapy to improve fetal growth or to ameliorate the adverse outcomes associated with IUGR [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Nutritional intra-amniotic therapy increases survival in a rabbit model of fetal growth restriction

et al. 2018

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ObjectiveTo evaluate the perinatal effects of a prenatal therapy based on intra-amniotic nutritional supplementation in a rabbit model of intrauterine growth restriction (IUGR).MethodsIUGR was surgically induced in pregnant rabbits at gestational day 25 by ligating 40–50% of uteroplacental vessels of each gestational sac. At the same time, modified-parenteral nutrition solution (containing glucose, amino acids and electrolytes) was injected into the amniotic sac of nearly half of the IUGR fetuses (IUGR-T group n = 106), whereas sham injections were performed in the rest of fetuses (IUGR group n = 118). A control group without IUGR induction but sham injection was also included (n = 115). Five days after the ligation procedure, a cesarean section was performed to evaluate fetal cardiac function, survival and birth weight.ResultsSurvival was significantly improved in the IUGR fetuses that were treated with intra-amniotic nutritional supplementation as compared to non-treated IUGR animals (survival rate: controls 71% vs. IUGR 44% p = 0.003 and IUGR-T 63% vs. IUGR 44% p = 0.02), whereas, birth weight (controls mean 43g ± SD 9 vs. IUGR 36g ± SD 9 vs. IUGR-T 35g ± SD 8, p = 0.001) and fetal cardiac function were similar among the IUGR groups.ConclusionIntra-amniotic injection of a modified-parenteral nutrient solution appears to be a promising therapy for reducing mortality among IUGR. These results provide an opportunity to develop new intra-amniotic nutritional strategies to reach the fetus by bypassing the placental insufficiency.

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Altered trajectory of neurodevelopment associated with fetal growth restriction

Dudink

Hüppi

Sizonenko

et al. 2022

Experimental Neurology

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Intrauterine growth restriction in very low birth weight newborns: Neonatal outcome

Cited by 5 publications

References 0 publications

Neonatal Outcome in Growth-Restricted Versus Appropriately Grown Preterm Infants

Neonatal Outcome in Growth-Restricted Versus Appropriately Grown Preterm Infants

Nutritional intra-amniotic therapy increases survival in a rabbit model of fetal growth restriction

Altered trajectory of neurodevelopment associated with fetal growth restriction

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