RESPIRATORY-DISTRESS SYNDROME IN INFANTS WITH IMPAIRED INTRAUTERINE GROWTH

The recently introduced Intrauterine growth curve, based on ultrasonic ally estimated foetal weights, was retrospectively applied to an inbor n population of 883 infants born before 33 gestational weeks at the Un iversity Hospital of Lund, during 1985-94. The estimation of birthweig ht deviation resulted in 630 (71.3%) infants with a birthweight approp riate for gestational age (AGA), 244 (27.6%) infants with a birthweigh t small for gestational age (SGA) and 9 (1.1%) infants with a birthwei ght large for gestational age. Birthweight deviation was associated wi th an increased mortality [odds ratio (OR) adjusted for gestational ag e 1.29 per SD (12%) change in birthweight for gestational age, 95% CI: 1.10-1.50; p = 0.002]. At gestational age 25-28 weeks, SGA-infants ha d an increased incidence of respiratory distress syndrome (RDS) as com pared to AGA-infants (OR adjusted for gestational age: 1.98, 95% CI: 1 .12-3.52; p = 0.019). At gestational age 29-32 weeks, SGA-infants had a lower incidence of RDS as compared to AGA-infants (OR adjusted for g estational age: OR 0.52, 95% CI: 0.34-0.80; p = 0.003). After adjustme nt for confounding variables, infants born at gestational age 25-28 we eks from mothers with pre-eclampsia, appeared to be a high-risk group for RDS, whereas at the age of 29-32 gestational weeks, negative birth weight deviation had a protective effect against. RDS. Antenatal corti costeroid administration appeared to have a less beneficial effect on mortality, RDS and cerebral haemorrhage in infants born SGA vs in thos e born AGA.