Neonatal outcome in small for gestational age infants: Do they really better?

Background: There still is a controversy as to the neonatal outcome of smal l for gestational age(SGA) infants compared to a appropriate for gestationa l age (AGA) preterm infants. As a part of a randomized multicenter trial on timing of bovine surfactant therapy, we aimed at investigating short-term outcome variables in SGA-infants compared with AGA-infants. Methods: SGA-infants were classified weighing below the 10th percentile at birth and were compared to AGA-infants in terms of prenatal and neonatal ch aracteristics and neonatal outcome. Results: A total of 317 infants were enrolled, 59 SGA- and 258 AGA-infants. Both groups did not differ in gestational age, however, SGA-infants had a lower birth weight. Preterm premature rupture of fetal membranes was observ ed more frequently in AGA-, preeclampsia in SGA-infants. The rate of intuba tion, severity of RDS, rate of surfactant administration, pulmonary airleak s and days on the ventilator did not differ between both groups. However pr olonged nasal CPAP, supplemental oxygen therapy and chronic lung disease at 28 days and 36 weeks was diagnosed more often in SGA-infants. Furthermore mortality was significantly higher in SGA-infants as well as total NICU and total hospital days. Conclusion: As SGA-infants have an increased mortality rate and an increase d risk for developing chronic lung disease, further studies should focus on prevention of intrauterine growth restriction and its complications.