Anthropometric Measurements in Premature Neonates Less than 32 weeks and Small for Gestational Age

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ESPR399
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Abstract: :

Background: Small for gestational age (SGA) is a designation given to newborns when the birth weight (BW) for gestational age (GA) is below the tenth percentile (%ile). Appropriate for gestational age (AGA) is when the BW for GA is between 10-90%ile. SGA neonates are at risk for perinatal asphyxia, growth failure, delay in catch up growth, neurodevelopmental abnormalities and metabolic syndrome in adulthood. There are limited data on premature neonates with GA <32 weeks (PN) and SGA. 

Objective: To identify anthropometric outcomes and characteristics in PN and SGA. 

Design/Methods: Retrospective case-control study of PN and SGA admitted in Flushing Hospital Medical Center and Jamaica Hospital Medical Center between September 2011 and October 2020. Cases include PN and SGA (G1) and controls include PN and AGA (G2). Data extracted from EHR include maternal age and comorbidities, mode of delivery, GA, gender, Apgar score at 1 minute and 5 minutes, W, length (L), head circumference (HC) %ile and Z-score (Zs) at birth and at discharge, days on total parenteral nutrition (TPN), necrotizing enterocolitis, and corrected GA at discharge. Data were analyzed using Mann-Whitney test and chi-square, p<0.05 was considered significant. 

Results: Of 595 PN charts reviewed, G1 included 29 (5%) and G2 equal number of controls matched for gender and GA. Male gender in 62%, GA ranged from 24 to 31 weeks, <28 weeks in 28%. G1 and G2 were compared for maternal age (30 vs 29 years, p=0.975), pre eclampsia (59 vs 24%, p=0.008), Apgar at 1 minute (7 vs 8, p=0.091), Apgar at 5 minutes (8 vs 8, p=0.118), median days on TPN (20 vs 13 days, p=0.001), necrotizing enterocolitis (14 vs 10%, p=0.687), median days to regain BW (9 vs 11days, p=0.039) and median corrected GA at discharge (39 vs 36 weeks, p=0). Anthropometric measurements, %ile and Zs at birth and discharge were consistently lower in G1 than in G2, p<0.001, Table 1. 

Conclusions: Anthropometric measurements, %ile and Zs were consistently and significantly lower in G1 at birth and at discharge. Despite more days on TPN, G1 regained their BW in fewer days. Preeclampsia was a common maternal comorbidity in G1.

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Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center
Flushing Hospital Medical Center

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