Weight for Gestational Age Affects the Mortality of Late Preterm Infants
Weight for Gestational Age Affects the Mortality of Late Preterm Infants
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DOI：
10.1542/peds.2008-3288
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发表时间：
2009-06-01
期刊：
影响因子：
8
通讯作者：
Young, Paul C.
中科院分区：
文献类型：
--
作者：
Pulver, Laurie S.;Guest-Warnick, Ginger;Young, Paul C.
背景资料。晚期早产儿死亡率高于足月儿。目的：本研究的目的是：(1)比较SGA、AGA和LGA的晚期早产儿、早产儿和足月儿的新生儿和婴儿死亡率；(2)确定每个WGA类别的新生儿和婴儿死亡的相对风险；(3)检查新生儿和婴儿死亡的原因。方法：研究方法。我们回顾了犹他州1999至2005年间出生且GA>；=34周的所有婴儿的相关出生和死亡证明数据。我们计算了每个GA/出生体重阶层的新生儿和婴儿死亡率，并以AGA足月儿为参考估计死亡率比率。结果：1999~2005年共有343322例GA>；=34周的新生儿死亡。晚期早产SGA新生儿在出生后第一个月死亡的可能性是足月AGA新生儿的44倍，第一年死亡的可能性是AGA新生儿的22倍。当排除了死于先天性疾病的婴儿时，SGA婴儿死亡率的差异持续存在，特别是那些出生在早产晚期的婴儿。结论SGA显著增加了早产晚期和早产儿本已较高的死亡率。这种增加的风险不能用SGA晚期早产儿中致命性先天性疾病的增加来完全解释。护理早产儿和早产儿的临床医生应该认识到他们的WGA类别。儿科2009；123：e1072-e1077
BACKGROUND. Late preterm infant mortality is higher than that for term newborns. The association between weight for gestational age (WGA) category and late preterm mortality has not been well described.OBJECTIVES. Our objectives for this research were as follows: ( 1) to compare neonatal and infant mortality rates of SGA, AGA, and LGA late preterm, early term, and term newborns; ( 2) to determine the relative risk of neonatal and infant death for each WGA category; and ( 3) to examine causes of neonatal and infant death. METHODS. We reviewed linked birth and death certificate data for all infants from Utah born between 1999 and 2005 with a GA >= 34 weeks. We calculated neonatal and infant mortality rates for each GA/birth weight stratum and estimated mortality rate ratios using AGA term infants as the reference. International Classification of Diseases, Ninth Revision, codes were used to classify cause of death.RESULTS. There were 343 322 newborns with GA >= 34 weeks from 1999 to 2005. Late preterm SGA infants were similar to 44 times more likely than term AGA newborns to die in their first month and 22 times more likely to die in their first year. When infants dying from congenital conditions were excluded, the differences in mortality rate ratios persisted for SGA infants, especially those born in the late preterm period.CONCLUSIONS. Being SGA substantially increases the already higher mortality of late preterm and early term newborns. This increased risk cannot be fully explained by an increased prevalence of lethal congenital conditions among SGA late preterm newborns. Clinicians caring for late preterm and early term newborns should be cognizant of their WGA category. Pediatrics 2009; 123: e1072-e1077