단일 3차 의료기관에서 부당 경량 출생아 들의 주산기 예후
Perinatal Outcomes of Small for Gestational Age Infants in a Korean Tertiary Medical Center
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Purpose: To examine the perinatal outcomes of small for gestational age (SGA) infants, compared with non- SGA infants and those born at 39 weeks, and to determine the optimal gestational age of delivery Methods: We performed a retrospective cohort study (n=7,580) for births at a tertiary hospital. SGA was stratified into severe (below 5th percentile) and moderate (5~10th percentile) groups. Statistical comparison was performed using the χ2 test and multivariable logistic regression models. Results: As compared to the non-SGA group at 38 weeks’ births, the odds of sepsis were significantly increased in the moderate SGA group (OR 2.84, 95% CI, 1.12~7.20) and severe SGA group (OR 3.63, 95% CI, 1.14~11.58). In addition, the odds of respiratory distress syndrome at 41 weeks’ births were significantly increased in moderate SGA (OR 15.32, 95% CI, 1.92~122.08) and severe SGA (OR 16.31, 95% CI, 1.18~226.14) groups, compared to it in the non-SGA group. The odds of other neonatal outcomes in the moderate SGA group were not significantly increased, as compared to the non-SGA group. However, the odds of neonatal intensive care unit admission and composite morbidity in the severe SGA group were significantly increased at 35, 36, 38, 39, 40, and 41 weeks’ births, as compared to the non-SGA group. There was no significant difference in neonatal outcomes from 38 to 41 weeks in moderate SGA, and from 37 to 41 weeks in severe SGA. Conclusion: If there is no medical indication, delivery at 39 weeks can be considered in SGA pregnancies. However, delivery can be planned from 37 gestational weeks in severe SGA pregnancies,with a subjective finding of fetal compromise.
Abstract
Purpose: To examine the perinatal outcomes of small for gestational age (SGA) infants, compared with non- SGA infants and those born at 39 weeks, and to determine the optimal gestational age of delivery Methods: We performed a retrospective cohort study (n=7,580) for births at a tertiary hospital. SGA was stratified into severe (below 5th percentile) and moderate (5~10th percentile) groups. Statistical comparison was performed using the χ2 test and multivariable logistic regression models. Results: As compared to the non-SGA group at 38 weeks’ births, the odds of sepsis were significantly increased in the moderate SGA group (OR 2.84, 95% CI, 1.12~7.20) and severe SGA group (OR 3.63, 95% CI, 1.14~11.58). In addition, the odds of respiratory distress syndrome at 41 weeks’ births were significantly increased in moderate SGA (OR 15.32, 95% CI, 1.92~122.08) and severe SGA (OR 16.31, 95% CI, 1.18~226.14) groups, compared to it in the non-SGA group. The odds of other neonatal outcomes in the moderate SGA group were not significantly increased, as compared to the non-SGA group. However, the odds of neonatal intensive care unit admission and composite morbidity in the severe SGA group were significantly increased at 35, 36, 38, 39, 40, and 41 weeks’ births, as compared to the non-SGA group. There was no significant difference in neonatal outcomes from 38 to 41 weeks in moderate SGA, and from 37 to 41 weeks in severe SGA. Conclusion: If there is no medical indication, delivery at 39 weeks can be considered in SGA pregnancies. However, delivery can be planned from 37 gestational weeks in severe SGA pregnancies,with a subjective finding of fetal compromise.
참고문헌 (24)
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