Morbidity and mortality in small for gestational age very preterm infants in a middle-income country

Marcia Mangiza; Danielle E Y Ehret; Erika M Edwards; Natasha Rhoda; Lloyd Tooke

doi:10.3389/fped.2022.915796

Morbidity and mortality in small for gestational age very preterm infants in a middle-income country

Front Pediatr. 2022 Aug 9:10:915796. doi: 10.3389/fped.2022.915796. eCollection 2022.

Authors

Marcia Mangiza¹, Danielle E Y Ehret^{2

3}, Erika M Edwards^{2

3

4}, Natasha Rhoda¹, Lloyd Tooke¹

Affiliations

¹ Groote Schuur Hospital, Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
² Vermont Oxford Network, Burlington, VT, United States.
³ Department of Paediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, United States.
⁴ Department of Mathematics and Statistics, University of Vermont, Burlington, VT, United States.

Abstract

Objective: To evaluate the impact of small for gestational age (SGA) on outcomes of very preterm infants at Groote Schuur Hospital (GSH), Cape Town, South Africa.

Study design: Data were obtained from the Vermont Oxford Network (VON) GSH database from 2012 to 2018. The study is a secondary analysis of prospectively collected observational data. Fenton growth charts were used to define SGA as birth weight < 10th centile for gestational age.

Results: Mortality [28.9% vs. 18.5%, adjusted risk ratio (aRR) 2.1, 95% confidence interval (CI) 1.6-2.7], bronchopulmonary dysplasia (BPD; 14% vs. 4.5%, aRR 3.7, 95% CI 2.3-6.1), and late-onset sepsis (LOS; 16.7% vs. 9.6%, aRR 2.3, 95% CI 1.6-3.3) were higher in the SGA than in the non-SGA group.

Conclusion: Small for gestational age infants have a higher risk of mortality and morbidity among very preterm infants at GSH. This may be useful for counseling and perinatal management.

Keywords: bronchopulmonary dysplasia; late onset sepsis; low- and middle-income countries; preterm; small for gestational age; very low birth weight (VLBW).