Association of neonatal outcome with birth weight for gestational age in Chinese very preterm infants: a retrospective cohort study

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2024年10月4日

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Liangliang Li,
Jing Guo,
Yanchen Wang,
Yuan Yuan,
Xing Feng,
Xinyue Gu,
Siyuan Jiang,
Chao Chen,
Yun Cao,
Jianhua Sun,
Shoo K Lee,
Wenqing Kang,
Hong Jiang,
Shoo K. Lee,
Lizhong Du Du,
Wenhao Zhou,
Falin Xu,
Xiuying Tian,
Huayan Zhang,
Yong Ji,
Zhankui Li,
Bin Yi,
Xindong Xue,
Chuanzhong Yang,
Dongmei Chen,
Sannan Wang,
Ling Liu,
Xirong Gao,
Hui Wu,
Changyi Yang,
Shuping Han,
Ruobing Shan,
Gang Qiu,
Xinnian Pan,
Youyan Zhao,
Mingxia Li,
Xuqiang Ye,
Lili Wang,
Jiangqin Liu,
Zhenlang Lin,
Yuan Shi,
Xiuyong Cheng,
Jiahua Pan,
Qin Zhang,
Qin Zhou,
Long Li,
Pingyang Chen,
Xiaoying Li,
Ling Yang,
Deyi Zhuang,
Yongjun Zhang,
Jinxing Feng,
Li Li,
Xinzhu Lin,
Yinping Qiu,
Kun Liang,
Li Ma,
Liping Chen,
Liyan Zhang,
Hongxia Song,
Zhaoqing Yin,
Mingyan Hei,
Huiwen Huang,
Jie Yang,
Dong Li,
Guofang Ding,
Jimei Wang,
Qianshen Zhang,
Xiaolu Ma,
Joseph Ting

摘要

Background

The neonatal outcomes across different percentiles of birth weight for gestational age are still unclear.

Methods

This retrospective cohort study was conducted within 57 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 25 provinces throughout China. Infants with gestational age (GA) 24⁺⁰-31⁺⁶ weeks who were admitted within 7 days after birth were included. The composite outcome was defined as mortality or any one of neonatal major morbidities, including necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (cPVL), severe retinopathy of prematurity (ROP), and sepsis. Multivariable logistic regressions using generalized estimating equation approach were conducted.

Results

A total of 8380 infants were included with a mean GA of 30 (28–31) weeks. Of these, 1373 (16.5%) were born at less than 28 weeks, while 6997 (83.5%) had a GA between 28 and 32 weeks. Our analysis indicated that the risk of composite outcomes was negatively associated with birth weight for gestational age, and compared to the reference group, the multiple-adjusted ORs (95%CI) of composite outcomes were 4.89 (3.51–6.81) and 2.16 (1.77–2.63) for infants with birth weight for gestational less than 10th percentile and 10th -30th percentile, respectively. The ORs (95%CI) of mortality, NEC, BPD, severe ROP, and sepsis in infants with birth weight for gestational age at 10th-30th percentile were 1.94 (1.56–2.41), 1.08 (0.79–1.47), 2.48 (2.03–3.04), 2.35 (1.63–3.39), and 1.39 (1.10–1.77), respectively.

Conclusion

Our study suggested that the risk of adverse neonatal outcomes increased significantly when the birth weight for gestational age was below the 30th percentile. Regular monitoring and early intervention are crucial for these high-risk infants.