Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center

Authors

  • Noémia Rosado da Silva Serviço de Pediatria. Unidade de Faro. Centro Hospitalar do Algarve. Faro.
  • Joana Oliveira Serviço de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa.
  • Alberto Berenguer Serviço de Neonatologia. Departamento de Pediatria. Hospital Universitário de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa.
  • André M. Graça Serviço de Neonatologia. Departamento de Pediatria. Hospital Universitário de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa.
  • Margarida Abrantes Serviço de Neonatologia. Departamento de Pediatria. Hospital Universitário de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa.
  • Carlos Moniz Serviço de Neonatologia. Departamento de Pediatria. Hospital Universitário de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa.

DOI:

https://doi.org/10.20344/amp.9599

Keywords:

Fetal Development, Fetal Growth Retardation, Infant, Premature, Small for Gestational Age, Morbidity

Abstract

Introduction: Prematurity and low birth weight have been associated with increased neonatal morbidity and mortality. This study aimed to evaluate possible risk factors for prematurity associated with fetal growth restriction and being small for gestational age and to determine the incidence of morbidity in these two groups of infants.
Material and Methods: Retrospective case-control study of newborns with gestational age of less than 32 weeks, with obstetric diagnosis of fetal growth restriction and with the clinical diagnosis of small for gestational age, admitted to the Neonatal Intensive Care Unit of a tertiary hospital for a period of six years.
Results: A total of 356 newborns were studied, with an incidence of 11% of fetal growth restriction and 18% of small for gestational age. Pre-eclampsia was the risk factor for gestation with higher statistical significance (47% vs 16%, p < 0.001) in small for gestational age newborns. There was also a higher incidence of mild bronchopulmonary dysplasia (66% vs 38%, p = 0.005), late sepsis (59% vs 37%, p = 0.003), retinopathy of prematurity (58% vs 26%, p = 0.003) and necrotizing enterocolitis (20% vs 9%, p = 0.005). Mortality was similar in all three groups.
Discussion: There were fewer newborn males diagnosed with fetal growth restriction during pregnancy compared to women. Significant differences were observed in the group of these infants regarding the occurrence of chorioamnionitis and pre-eclampsia in comparison to the control group. Newborns with fetal growth restriction and small for age had higher scores on clinical risk indices compared to the control group. In general, small for gestational age newborns had a higher incidence of morbidity than infants with fetal growth restriction and the control group.
Conclusion: Advances in neonatal intensive care decreased mortality in preterm infants. However, there are still significant differences in the incidence of morbidity in newborns with growth compromise. The collaboration between obstetricians and neonatologists provides the basis for a correct clinical evaluation, early signaling and global intervention on these newborns, with a significant impact on short and long-term prognosis.

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Published

2018-11-30

How to Cite

1.
Silva NR da, Oliveira J, Berenguer A, Graça AM, Abrantes M, Moniz C. Morbidity in Prematurity Associated with Fetal Growth Restriction: Experience of a Tertiary Care Center. Acta Med Port [Internet]. 2018 Nov. 30 [cited 2023 Feb. 1];31(11):648-55. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/9599

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Original