Abstract
Aim To determine whether being small for gestational age (SGA) is associated with increased
mortality and short-term morbidity for extremely low birth weight (ELBW) babies at
Townsville University Hospital (TUH).
Methods All babies with a birth weight of <1,000 g born at TUH between January 1, 2010 and
January 1, 2021 were included. Data from the neonatal unit's NeoDATA database were
used to compare mortality and short-term morbidity outcomes for babies categorized
as SGA (birth weight <10th centile) or not. Statistical analyses were used to determine
associations between being SGA and survival to discharge, intubation for mechanical
ventilation, duration of respiratory support, chronic neonatal lung disease (CNLD),
home oxygen, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL),
retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), sepsis, time to
full enteral feeds, and duration of admission.
Results Of 461 ELBW babies, 62 (13.4%) were SGA. The SGA babies were significantly smaller
at 714 (580–850) versus 810 (700–885) g (p < 0.001) and of advanced gestational age at 28.6 (26.6–30.2) versus 25.4 (24.4–26.6)
weeks (p < 0.001). No significant difference in mortality existed, with 85% of SGA babies
and 84% of others surviving. On univariate analysis, being SGA was associated with
significant reductions in intubation for mechanical ventilation (p < 0.001), duration of respiratory support (p < 0.001), intraventricular hemorrhage (p = 0.002), NEC (p = 0.037), and admission duration (p = 0.038). After controlling for confounding factors, no outcomes were independently
associated with being SGA. Logistic regression found survival was associated with
birth weight (p = 0.030), gestational age (p = 0.007), and antenatal corticosteroids (p = 0.008).
Conclusions Being SGA is not an independent predictor of mortality nor adverse short-term morbidity
for ELBW babies.
Keywords
Small for gestational age - growth restricted - extremely low birth weight - premature
- mortality - morbidity