Effects of suboptimal intra-uterine growth on preterm infants between 30 and 32 weeks' gestation.

OBJECTIVE

To investigate the affects of suboptimal intra-uterine growth on the outcome of low-birth-weight (LBW) infants.

DESIGN

Prospective observational study.

SETTING

Neonatal unit of a tertiary care hospital.

PATIENTS: A total of 104 LBW infants with a gestation of 30-32 weeks were selected from a larger cohort that had previously been studied to ascertain the prevalence of respiratory distress syndrome (RDS) and periventricular-intraventricular haemorrhage (PV-IVH).

OUTCOME MEASURES: Multivariate analysis was used to examine the association between RDS, PV-IVH and death, and the adequacy of intra-uterine growth.

RESULTS

Infants with a higher birth weight ratio or birth weight > or = 25th percentile had an increased risk of developing RDS, particularly where ventilatory support was required. However, PV-IVH was associated with immediate perinatal events and not with intra-uterine growth. Mortality was not affected by intra-uterine growth, since those < 25th percentile. In spite of being at lower risk for RDS, showed a trend towards more infection-related deaths.

CONCLUSIONS

The 'intra-uterine stress' experienced by infants with suboptimal intra-uterine growth appears to protect partially against RDS, but confers no overall advantage in terms of survival.