The association between small-for-gestational age neonate at term and long term pediatric respiratory morbidity

Galia Hadad-Peles, Eyal Sheiner, Dorit Paz-Levy, Tamar Wainstock

Research output: Contribution to journalMeeting Abstract

Abstract

Objective
Small for gestational age (SGA), was reported as a risk factor for immediate respiratory morbidity in neonates. We aim to investigate whether delivery of an SGA neonate poses an increased risk for long-term respiratory morbidity during childhood.

Study Design
A retrospective population-based cohort analysis was performed comparing the risk of long-term respiratory morbidity between SGA (defined as birth weight below the 5th percentile for gestational age and gender), and appropriate for gestational age (AGA) newborns. The analysis included all singleton deliveries at term (37 - 42 weeks) occurring between 1991 - 2017 at a single tertiary medical center. Fetuses with congenital malformations, multiple pregnancies, cases of perinatal mortality and large for gestational age neonates were excluded. A Kaplan-Meier survival curve was used to compare cumulative respiratory morbidity incidence up to the age of 18 years, and a Cox proportional hazards model was used to control for confounders.

Results
During the study period, 215,805 deliveries met the inclusion criteria; 4.8% (n = 10,415) were diagnosed as SGA neonates. During the study period, rate of hospitalizations involving respiratory morbidity was significantly higher in the SGA group as compared with the AGA group (5.2% vs. 4.7%, OR = 1.1, 95% CI 1.01 - 1.22, p = 0.02, Table). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of respiratory morbidity in the SGA group (log rank p = 0.045, Figure). In the Cox proportional hazards model, controlled for relevant clinical confounders such as maternal age, maternal diabetic and hypertensive disorders during pregnancy, SGA was found as an independent risk factor for long-term pediatric respiratory morbidity (adjusted HR=1.1, 95% CI 1.003 - 1.19, p = 0.043).

Conclusion
Being born SGA at term is an independent risk factor for long-term pediatric respiratory morbidity.
Original languageEnglish GB
Pages (from-to)S87-S88
JournalAmerican Journal of Obstetrics and Gynecology
Volume222
Issue number1
DOIs
StatePublished - Jan 2020

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