454: Small for gestational age at term: an independent risk factor for long-term pediatric morbidity

Objective
To investigate whether being delivered small for gestational age (SGA) at term poses an increased risk for long-term pediatric morbidity.
Study Design
A retrospective population-based cohort study compared the incidence of long-term pediatric hospitalizations due to cardiovascular, hematologic, respiratory, neurological and urinary morbidity of children born SGA at term (37-42 weeks gestation). Deliveries occurred between the years 1991-2014 in a tertiary medical center. Congenital malformations as well as multiple pregnancies were excluded. A multivariate generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters.

Results
During the study period 236,504 deliveries met the inclusion criteria; of which 4.8% were SGA neonates (n=11,319). During the follow-up period, children born SGA at term had a significantly higher rate of long-term cardiovascular, hematologic and respiratory morbidity (table). Using multivariable GEE logistic regression models, controlling for the time-to-event, maternal age and maternal diabetes mellitus, being born SGA at term was found to be an independent risk factor for long-term cardiovascular, hematologic and respiratory disease during childhood (table).
Conclusion
Being delivered SGA at term is an independent risk factor for long-term cardiovascular, hematologic and respiratory morbidity of the offspring.