Gebelik haftasına göre küçük olmanın prematüre morbiditelerine etkisi

Year 2022, Volume: 27 Issue: 3, 287 - 292, 27.09.2022

Duran Yıldız , Burak Ceran , Ufuk Çakır , Ali Ulaş Tuğcu , Cüneyt Tayman

https://doi.org/10.21673/anadoluklin.1096789

Cited By: 1

Abstract

Amaç: Gebelik yaşına göre düşük doğum ağırlığı (small for gestational age: SGA) olan prematüre bebeklerin prematüreliğe ek olarak hangi morbiditeler açısından daha riskli olduğu konusundaki kanıtlar yetersizdir. Çalışmamızda gebelik haftası <32 hafta olan SGA prematüre bebeklerin morbidite ve mortalite açısından risklerinin değerlendirilmesi amaçlanmıştır.

Yöntemler: Gebelik haftası <32 hafta olup SGA olan bebeklerin morbiditeleri ve mortalite verileri, <32 gebelik haftasında doğan gebelik haftasına uygun doğum ağırlığı ile doğan (appropriate for gestational age: AGA) bebekler ile karşılaştırıldı.

Bulgular: Çalışmaya 122 (%24,6) SGA ve 372 (%75,4) AGA bebek olmak üzere toplam 494 prematüre bebek dâhil edildi. Doğumda SGA olan bebeklerde AGA olanlara göre annede preeklampsi, nekrotizan enterokolit (NEK), prematüre retinopatisi (ROP), intraventiküler kanama (İVK) oranı daha yüksekti. Ayrıca SGA olanlarda AGA olanlara göre tam enteral beslenmeye geçiş zamanı, yoğun bakımda yatış süresi anlamlı olarak daha yüksekti (p<0,05).

Sonuç: Gebelik haftaları benzer olsa da SGA ve prematüre olan bebeklerde, AGA olan bebeklere göre İVK, ROP ve NEK gibi prematüre morbiditeleri daha yüksekti.

Keywords

morbidite, mortalite, yenidoğan

Supporting Institution

yok

Project Number

yok

Thanks

yok

Effects of being small for gestational age on morbidities of prematurity

Abstract

Aim: There is insufficient evidence on which morbidities are more risky for premature babies with small for gestational age (SGA) in addition to prematurity. In our study, it was aimed to evaluate the risks of SGA premature babies with a gestational age of <32 weeks, in terms of morbidities and mortality.

Methods: The morbidity and mortality data of SGA infants with a gestational age <32 weeks were compared with infants born at <32 gestational weeks with appropriate birth weight (appropriate for gestational age: AGA).

Results: A total of 494 premature infants, including 122 (24.6%) SGA and 372 (75.4%) AGA infants, were enrolled into the study. Infants with SGA had a higher rate of maternal preeclampsia, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and intraventricular bleeding (IVH) than those with AGA. Additionally, the transition time to full enteral nutrition and the length of stay in the intensive care unit were significantly higher in infants with SGA compared to those with AGA (p<0.05).

Conclusion: Although the gestational weeks are similar, morbidities of prematurity such as IVH, ROP and NEC are higher in SGA and premature infants, compared to infants with AGA.

Keywords

morbidity, mortality, newborn

Project Number

yok

References

• Kadıoğlu Şimşek G, Büyüktiryaki M, Kanmaz Kutman HG, et al. Comparison of mortality and morbidities in small and appropriate for gestational age preterm infants. Namik Kemal Med J. 2019;7:83-9.
• Avorgbedor F, Gondwe KW, Zou B, Conklin JL, Yeo S. A systematic review on outcomes of preterm small for gestational infants born to women with hypertensive disorders in pregnancy. J Perinat Neonatal Nurs. 2021;35(4):E58-E68.
• García-Basteiro AL, Quintó L, Macete E, et al. Infant mortality and morbidity associated with preterm and small-for-gestational-age births in Southern Mozambique: A retrospective cohort study. PLoS One. 2017;12(2):e0172533.
• Boghossian NS, Geraci M, Edwards EM, Horbar JD. Morbidity and mortality in small for gestational age infants at 22 to 29 weeks’ gestation. Pediatrics. 2018;141(2):e20172533.
• Nobile S, Marchionni P, Carnielli VP. Neonatal outcome of small for gestational age preterm infants. Eur J Pediatr. 2017;176(8):1083-8.
• Eriksson L, Haglund B, Odlind V, Altman M, Ewald U, Kieler H. Perinatal conditions related to growth restriction and inflammation are associated with an increased risk of bronchopulmonary dysplasia. Acta Paediatr. 2015;104(3):259-63.
• Satar M, Arisoy AE, Celik IH. Turkish Neonatal Society guideline on neonatal infections-diagnosis and treatment. Turk Pediatri Ars. 2018;53(Suppl 1):S88-S100.
• Canpolat FE, Kadioglu Simsek G, Webbe J, et al. Late administration of surfactant may increase the risk of patent ductus arteriosus. Front Pediatr. 2020;8(3):130.
• Volpe JJ. Impaired neurodevelopmental outcome after mild germinal matrix-intraventricular hemorrhage. Pediatrics. 2015;136(6):1185-7.
• Cakir U, Tayman C, Karacaglar NB, Beser E, Ceran B, Unsal H. Comparison of the effect of continuous and standard intermittent bolus paracetamol infusion on patent ductus arteriosus. Eur J Pediatr. 2021;180(2):433-40.
• Cakir U, Tayman C, Yucel C, Ozdemir O. Can IL-33 and Endocan be new markers for retinopathy of prematurity? Comb Chem High Throughput Screen. 2019;22(1):41-8.
• Cakir U, Tayman C, Yucel C. A novel diagnostic marker for the severity of bronchopulmonary dysplasia in very low birth weight ınfants: Interleukin-33. Pediatr Allergy Immunol Pulmonol. 2019;32(1):12-7.
• Cakir U, Tayman C, Yarci E, et al. Novel useful markers for follow-up of necrotizing enterocolitis: Endocan and Interleukin-33. J Matern Fetal Neonatal Med. 2020;33(14):2333-41.
• Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr. 2003;3(12):13.
• Malhotra A, Allison BJ, Castillo-Melendez M, Jenkin G, Polglase GR, Miller SL. Neonatal morbidities of fetal growth restriction: pathophysiology and impact. Front Endocrinol (Lausanne). 2019;10(2):55.
• Civan H. Assessment of neonatal morbidity and maternal risk factors in term and small for gestational age (SGA) babies. Pediatric Practice and Research. 2019;7(Ek):381-9.
• Mendez-Figueroa H, Truong VT, Pedroza C, Chauhan SP. Morbidity and mortality in small-for-gestational-age infants: a secondary analysis of nine MFMU Network Studies. Am J Perinatol. 2017;34(4):323-32.
• Harteman JC, Nikkels PG, Kwee A, Groenendaal F, de Vries LS. Patterns of placental pathology in preterm infants with a periventricular haemorrhagic infarction: association with time of onset and clinical presentation. Placenta. 2012;33(10):839-44.
• Oh MA, Barak S, Mohamed M, Penn AA. Placental pathology and intraventricular hemorrhage in preterm and small for gestational age infants. J Perinatol. 2021;41(4):843-9.