Small for gestational age and extremely low birth weight infant outcomes

Background: Small for gestational age (SGA) infants are less likely to develop RDS, but more likely to develop bronchopulmonary dysplasia (BPD) and have a higher mortality. Our aim was to focus on outcomes of those with a birth weight less than or equal to 750 gms. Methods: The mortality, BPD severity, necrotising enterocolitis (NEC), home oxygen requirement and length of hospital stay were determined according to SGA status of all eligible infants in a five year period admitted within the first 24 hours after birth. Results: The outcomes of 84 infants were assessed, 35 (42%) were SGA. The SGA infants were more mature (p<0.001), had a lower birth weight centile (p<0.001) and a greater proportion exposed to antenatal corticosteroids (p=0.022). Adjusted for GA, there was no significant difference in mortality between the two groups (p=0.242), but a greater proportion of the SGA infants developed severe BPD (p=0.025). The SGA infants had a lower weight z-score at discharge (-3.64 versus -1.66) (p=0.001), but a decrease in z-score from birth to discharge was observed in both groups (median -1.53 versus -1.07, p=0.256). Conclusions: Despite being more mature, the SGA infants had a similar mortality rate and a greater proportion developed severe BPD.