Comparison of Cardiac Function Among Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA) Preterm (28-34 Weeks) Neonates During the First 72 Hours of Life: A Prospective Study.

OBJECTIVE

Small for gestational age (SGA) neonates are known to have altered cardiovascular adaptation; however, data on cardiac function during the early transitional period in preterm neonates remain limited. This study aimed to compare cardiac function during the first 72 h of life between preterm SGA and appropriate for gestational age (AGA) neonates.

METHODS

In this prospective study done at an Indian tertiary care neonatal centre, cardiac function by echocardiography was compared at three predefined time points during the first 72 h of life between hemodynamically stable preterm (28 0/6-34 6/7) SGA and AGA neonates.

RESULTS

A total of 57 SGA and 91 AGA neonates were studied. On descriptive analysis, systolic and diastolic filling parameters were comparable between SGA and AGA neonates across time points. On repeated measures analysis adjusted for gestational age, sex, maternal factors, and antenatal doppler findings, there was no significant group difference in the left ventricular output (primary outcome variable). Among the secondary outcome variables, ejection fraction and isovolumic relaxation time showed significant differences on initial analysis; however, these did not remain significant after Bonferroni correction for multiple comparisons. Perfusion index demonstrated a significant time effect that persisted after Bonferroni correction, indicating dynamic changes during the early transitional period.

CONCLUSION

Hemodynamically stable SGA and AGA neonates had comparable left ventricular output and other systolic and diastolic functional parameters, except for a time-related change in perfusion index, likely reflecting physiological transition.