EFFECTS OF SUBOPTIMAL INTRAUTERINE GROWTH ON PRETERM INFANTS BETWEEN 30-WEEKS AND 32-WEEKS GESTATION

Objective. To investigate the effects of suboptimal intrauterine growt h on the outcome of low-birth-weight (LBW) infants. Design. Prospectiv e observational study. Setting. Neonatal unit of a tertiary care hospi tal. Patients. A total of 104 LBW infants with a gestation of 30 - 32 weeks were selected from a larger cohort that had previously been stud ied to ascertain the prevalence of respiratory distress syndrome (RDS) and periventricular-intraventricular haemorrhage (PV-IVH). Outcome me asures. Multivariate analysis was used to examine the association betw een RDS, PV-IVH and death, and the adequacy of intra-uterine growth. R esults. Infants with a higher birth weight ratio or birthweight greate r than or equal to 25th percentile had an increased risk of developing RDS, particularly where ventilatory support was required. However, PV -IVH was associated with immediate perinatal events and not with intra -uterine growth. Mortality was not affected by intra-uterine growth, s ince those < 25th percentile, in spite of being at lower risk for RDS, showed a trend towards more infection-related deaths. Conclusions. Th e 'intra-uterine stress' experienced by infants with suboptimal intra- uterine growth appears to protect partially against RDS, but confers n o overall advantage in terms of survival.