Methods
The purpose of this study was to comparatively evaluate the neonatal
evolution and the rate of short-term neonatal complications of the
preterm infants with normal weight for the gestational age and of the
preterm infants with low weight for the gestational age, as well as of
the term infants small for gestational age (SGA). We carried out a
retrospective study using the database of the neonates of the
Neonatology Clinic of the Bucharest Emergency University Hospital,
hospital with a third degree maternity ward, for a period of 3 years.
The cases of preterm birth were selected according to the World Health
Organization (WHO) definition of birth before 37 full weeks of
gestation. Only live newborn cases were selected and analyzed. The cases
of premature newborns were classified in two categories according to the
birth weight, namely with appropriate weight for the gestational age,
named group 1 and including 78 cases and with low weight according to
the gestational age corresponding to the international growth curves,
named group 2 and including 1121 case. Therefore, the low weight cases
selected were those in which the weight at birth was below the two
standard deviations of the growth curves corresponding to the
gestational age. There were also cases of babies with low birth weight
born at term who were selected for the purpose of comparative analysis
of their neonatal prognosis (group 3 including 206 cases). The
parameters that were analyzed included gestational weight and age as
directional criteria, fetal sex, mode of birth (cesarean or spontaneous
birth), and Apgar index at 1 minute as a marker of immediate postnatal
fetal status. Meanwhile, the obstetric features analyzed included fetal
presentation, the spectrum of the spectrum of hypertensive disorders of
pregnancy, fetal malformations, nuchal cord and true umbilical cord
knot. The immediate neonatal complications and neonatal markers analyzed
included: cardio-vascular arrest, acute respiratory failure,
ulcer-necrotic enterocolitis, hypoxia, respiratory distress, cerebral
edema, intraventricular hemorrhage, cerebral hemorrhage, pulmonary
hemorrhage, patent ductus arteriosus, neonatal hypoglycemia,
retinopathy, anemia, hemorrhagic disease, disseminated vascular
coagulation, hyaline membrane disease, neonatal sepsis, need for
neonatal intensive care, and death. A total of 1405 subjects were
analyzed and were divided into 3 study groups: group 1 representing
live, preterm infants with low weight for gestational age; group 2
representing living newborns, premature but with weight corresponding to
the gestational age; and group representing term newborns with low birth
weight. The cumulative and comparative analysis by frequency and sex
were analyzed in the first phase, following the cumulative and
comparative analysis of all the neonatal and obstetrical parameters of
the cases in the 3 groups and the statistical analysis regarding the
significant difference, or the frequency of the complications analyzed,
in those 3 study groups through the chi-square test. The results were
analyzed and interpreted according to the obtained P value; P
<0.05 was considered to be statistically significant.
The data collected retrospectively did not contain personal information
and only the ethics committee agreement of the University Emergency
Hospital of Bucharest was required and obtained without the need of
informed consent or the consent of the patient/legal representative in
the case of minors.