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DOI: 10.1055/s-0034-1395479
Outcomes for Symmetrical and Asymmetrical Small for Gestational Age Preterm Infants in Canadian Tertiary NICUs
Publication History
02 June 2014
09 September 2014
Publication Date:
23 December 2014 (online)
![](https://www.thieme-connect.de/media/ajp/201508/lookinside/thumbnails/10-1055-s-0034-1395479_140178-1.jpg)
Abstract
Objective This study aimed to compare the outcomes for symmetrical (sSGA) versus asymmetrical (aSGA) small for gestational age (SGA) < 32 weeks preterm infants.
Study Design A total of 12,179 eligible infants admitted to the Canadian tertiary neonatal intensive care units (NICUs) over a 7-year-period in the Canadian Neonatal Network database were subcategorized as aSGA (n = 536), sSGA (n = 732), or appropriate for GA (AGA, n = 10,911). Baseline demographics, mortality, and major morbidities were compared using multivariable analysis to calculate adjusted odds ratios (AOR) and 95% confidence interval (CI).
Results sSGA had higher GA (p < 0.01) and more antenatal tobacco exposure (p = 0.03). Although both the SGA groups had worse outcomes than AGA controls, aSGA versus sSGA comparison revealed lower odds (AOR [CI]) for mortality and chronic lung disease (CLD) for aSGA in the entire cohort (0.45 [0.27, 0.75] and 0.61 [0.44, 0.84], respectively) as well as for infants < 28 weeks GA (0.50 [0.27, 0.92] and 0.47 [0.29, 0.77], respectively). aSGA infants < 28 weeks GA had comparable outcomes to AGA except higher odds for CLD (1.61 [1.13, 2.27]). sSGA infants needed longer hospital stay and had higher use of oxygen and continuous positive airway pressure than aSGA.
Conclusion Among SGA infants < 32 weeks GA, significant intragroup differences exist in the neonatal outcomes and hospital resource utilization depending upon the presence or absence of relative “head sparing.”
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