Propensity-Matched Comparison of Very Preterm Small- and Appropriate-for-Gestational-Age Neonates

Anne, Rajendra Prasad; Vardhelli, Venkateshwarulu; Oleti, Tejo Pratap; Murki, Srinivas; Reddy, Gopireddy Murali Mohan; Deshabhotla, Saikiran; Kallem, Venkat Reddy; Vadije, Pravin Rao

doi:10.1007/s12098-021-03878-3

Cited by 9 publications

(15 citation statements)

References 24 publications

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“…Data in this study are in agreement with the literature showing an association of NEC with SGA or BW Z-score. [3,[9][10][11][12]. Data in this study confirmed the association of SGA with maternal hypertension [26].…”

Section: Discussionsupporting

confidence: 82%

“…Data in this study are in agreement with the literature showing an association of NEC with SGA or BW Z-score. 3,[9][10][11][12] Data in this study confirmed the association of SGA with maternal hypertension. 26 A systematic review of observational studies in preterm SGA infants showed no significant difference in NEC between those born to mothers with pregnancyinduced hypertension or hypertensive disorders of pregnancy and those born to mothers without hypertensive disorders (two studies, aOR 0.78, 95% confidence interval [CI] 0.60, 1.01).…”

Section: Discussionsupporting

confidence: 82%

“…multicenter cohorts (10,353 VLBW infants,24,596 infants born at 26-33 weeks' GA, and 20,223 VLBW infants [3,9,12] and a propensity-matched study of 909 infants born at 26-31 weeks' GA [10].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…7 In a single-site matched case-control study of 950 infants born at any GA (475 SGA and 475 GAmatched appropriate for GA) without congenital malformations, the frequency of NEC was higher in SGA than in controls in bivariate analysis but not in multivariate analysis and did not increase with severity of SGA. 8 In contrast, SGA infants were found to be at increased risk of developing NEC when compared with non-SGA infants in several studies, 3,[9][10][11][12] including four large multicenter cohorts (10,353 VLBW infants, 24,596 infants born at 26-33 weeks' GA, and 20,223 VLBW infants) 3,9,12 and a propensity-matched study of 909 infants born at 26 to 31 weeks' GA. 10 The controversy about the relationship of NEC with SGA might result from heterogeneity of study design including sample size, inclusion criteria (e.g., BW or GA), excluding or adjusting for congenital malformations, and from nonlinear relationship between the frequency of NEC and severity of growth restriction. In the multicenter Chinese cohort of 24,596 infants born at 26-33 weeks' GA (not excluding congenital malformations) listed above, the frequency of NEC was higher in SGA but in multivariate analysis it was not different in those with BW at third to tenth centile versus those with BW less than third centile; NEC was more frequent in SGA than non-SGA only in the subgroup with GA !…”

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confidence: 99%

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Impact of Size for Gestational Age on Multivariate Analysis of Factors Associated with Necrotizing Enterocolitis in Preterm Infants: Retrospective Cohort Study

Sánchez-Rosado,

Reis,

Jaleel

et al. 2023

Am J Perinatol

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Objective: Necrotizing enterocolitis (NEC) primarily affects preterm, especially small for gestational age (SGA), infants. This study was designed: (1) To describe frequency and timing of NEC in SGA versus non-SGA infants and (2) to assess whether NEC is independently associated with the severity of intrauterine growth failure. Study design: Retrospective cohort study of infants without severe congenital malformations born <33 weeks gestational age (GA) from 2009-2021. The frequency and time of NEC were compared between SGA and non-SGA infants. Multivariate logistic regression was used to assess whether NEC was independently associated with intrauterine growth restriction. Severe growth restriction was defined as birthweight Z-score <-2. Results: Among 2940 infants, the frequency of NEC was higher in SGA than in non-SGA infants [25/268 (9.3%) vs 110/2672 (4.1%), respectively, P<0.001]. NEC developed two weeks later in SGA than non-SGA infants. In multivariate analysis, the adjusted odds of NEC increased with extreme prematurity (<28 weeks GA) and with severe but not moderate growth restriction. The adjusted odds of NEC increased with urinary tract infection or sepsis within a week prior to NEC, were lower in infants fed their mother's own milk until discharge and did not change over 5 epochs. NEC was independently associated with antenatal steroid (ANS) exposure in infants with BW Z-score <0. Conclusions: NEC was more frequent in SGA than in non-SGA infants and developed two weeks later in SGA infants. NEC was independently associated with severe intrauterine growth failure and with ANS exposure in infants with BW Z-score <0.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Section: Accepted Manuscriptmentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of Size for Gestational Age on Multivariate Analysis of Factors Associated with Necrotizing Enterocolitis in Preterm Infants: Retrospective Cohort Study

Sánchez-Rosado,

Reis,

Jaleel

et al. 2023

Am J Perinatol

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“…Previous studies have reported several risk factors associated with an increased risk of mortality or morbidities in very preterm infants, e.g., lower gestational age (GA) and small for GA (SGA). [11][12][13][14][15][16] However, there are few studies which have examined risk factors for composite outcomes (mortality and/or morbidities) in middle-or low-income countries. If the modifiable risk factors could be identified, perhaps the rates could be decreased especially in resourcelimited settings.…”

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confidence: 99%

Risk Factors for Mortality or Major Morbidities of Very Preterm Infants: A Study from Thailand

et al. 2023

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Objective Very preterm neonates have high rates of composite outcomes featuring mortality and major morbidities. If the modifiable risk factors could be identified, perhaps the rates could be decreased especially in resource-limited settings. Study Design We performed a prospective study in a Thai neonatal intensive care unit to identify the risk factors of composite outcomes between 2014 and 2021. The inclusion criterion was neonates who were born in our hospital at a gestational age (GA) of less than 32 weeks. The exclusion criteria were neonates who died in the delivery room or had major congenital anomalies. The composite outcomes were analyzed by multivariable logistic regression with adjusted odds ratios (aOR) and a 95% confidence interval (CI). Results Over the 8-year study period, 555 very preterm inborn neonates without major birth defects were delivered. The composite outcomes were 29.4% (163/555). The medians (interquartile ranges) of GA and birthweights of the neonates were 29 (27, 31) weeks and 1180 (860, 1475) grams, respectively. By multivariable analysis, GA (aOR 0.65; 95% CI 0.55–0.77), small for GA (aOR 4.93; 95% CI 1.79–13.58), multifetal gestation (aOR 2.23; 95% CI 1.12–4.46), intubation within 24 h (aOR 5.39; 95% CI 1.35–21.64), and severe respiratory distress syndrome (aOR 5.00; 95% CI 1.05–23.89) were significantly associated with composite outcomes. Conclusion Very preterm infants who had a lower GA, were small for GA, twins or more, respiratory failure on the first day of life, and severe respiratory distress syndrome were associated with mortality and/or major morbidities.

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Comparison of Fenton, INTERGROWTH-21st, and Population-Based Growth Charts in Predicting Outcomes of Very Preterm Small-for-Gestational-Age Neonates

Anne

Vardhelli

Murki³

et al. 2022

Indian J Pediatr

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Propensity-Matched Comparison of Very Preterm Small- and Appropriate-for-Gestational-Age Neonates

Cited by 9 publications

References 24 publications

Impact of Size for Gestational Age on Multivariate Analysis of Factors Associated with Necrotizing Enterocolitis in Preterm Infants: Retrospective Cohort Study

Impact of Size for Gestational Age on Multivariate Analysis of Factors Associated with Necrotizing Enterocolitis in Preterm Infants: Retrospective Cohort Study

Risk Factors for Mortality or Major Morbidities of Very Preterm Infants: A Study from Thailand

Comparison of Fenton, INTERGROWTH-21st, and Population-Based Growth Charts in Predicting Outcomes of Very Preterm Small-for-Gestational-Age Neonates

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