DO GROWTH-RETARDED PREMATURE-INFANTS HAVE DIFFERENT RATES OF PERINATAL MORBIDITY AND MORTALITY THAN APPROPRIATELY GROWN PREMATURE-INFANTS

Objective: To determine if perinatal morbidity and mortality differ in growth-retarded, small for gestational age (SGA), premature infants a nd appropriate for gestational age (AGA) infants. Methods: All consecu tive, singleton, nondiabetic, preterm pregnancies delivered over a 15- year period were analyzed. Infants were categorized as SGA (at or belo w the tenth percentile) or AGA (11th to the 89th percentiles), then st ratified by birth weight and gestational age categories. Perinatal mor bidity and mortality were examined. Results: We studied 4183 preterm d eliveries, 1012 of them SGA and 3171 of them AGA. Overall, we found si gnificantly higher rates of fetal and neonatal death in the SGA group. Stratification by gestational age revealed significantly higher rates of neonatal death for the SGA group compared with the AGA group in ea ch gestational age category. Overall, comparison also revealed signifi cantly higher rates of fetal heart rate abnormality in the SGA group b ut no difference ire neonatal sepsis, birth trauma, cesarean delivery, hyaline membrane disease, or congenital anomalies. Conclusion: Growth -retarded premature infants have a significantly higher risk of morbid ity and mortality, both before and after delivery, than do appropriate ly grown infants.