OUTCOMES OF INFANTS WITH BIRTH WEIGHTS UN DER THE 3RD CENTILE ADMITTED TO INTENSIVE-CARE UNITS - NEONATAL MORBIDITY AND MORTALITY - ONE-YEAR OUTCOMES

Small-for-dates neonates (birth weight [BW] <10th centile) form a very heterogeneous population. The objective of this study was to determin e the causes of intra uterine growth retardation (IUGR), neonatal morb idity and mortality, and one-year outcomes in the 165 neonates (145 pr eterm, 20 term) with BWs <3rd centile admitted to an intensive care un it between 1988 and 1993 (5.8% of all admissions). Placental insuffici ency was the cause of IUGR in 75% of cases. Virtually all cases were d etected prenatally. Specific neonatal disorders due to fetal anoxia In cluded enteropathy, thrombocytopenia, neutropenia, anoxic hepatopathy, and hemodynamic alterations secondary to myocardial ischemia. In cont rast, pulmonary and neurologic complications seemed less common and le ss severe. There was no excess mortality (18 neonatal deaths). Outcome s in 110 of the 147 survivors were evaluated at one year of age: catch -up growth was only partial (weight and height were decreased by more than 2SD in half the patients) and 104 patients had an acceptable neur odevelopmental outcome (two deaths, three severe developmental delay, one spasticity of the lower limbs). However, longitudinal studies of I UGR infants have shown an increase in the frequency of minor neurologi c dysfunction suggesting that prolonged follow-up is necessary.