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摘要
objectives: to evaluate the clinical severity and proportionality of small for gestational age, very low birth weight neonates (%26lt; 1,500 g) and to estimate the neonatal mortality risk associated with the condition of being small for gestational age according to the degree of severity and proportionality. methods: observational design. all of the neocosur collaborative group%26apos;s very low birth weight infants (25-36 weeks%26apos; gestation) were included (n = 1,518). anthropometric indices: birth weight %26lt; 3rd and 10th percentile. severity (fetal growth ratio = observed weight/mean birth weight for gestational age); no growth restriction: fetal growth ratio 0.90-1.10, mild: fetal growth ratio 0.80-0.89, moderate: fetal growth ratio 0.75-0.79 and severe: fetal growth ratio %26lt; 0.75. proportionality: coefficient of bimodality and z score for ponderal index (pi = g/cm3 *100). neonatal mortality until discharge. results: %26lt; 3rd percentile: 13.5% (p %26lt; 0.001); %26lt; 10th percentile: 31% (p %26lt; 0.001); fetal growth ratio: 0.90㊣0.21 (p %26lt; 0.001), mild restriction: 20.8%, moderate restriction: 8.7% and severe restriction: 32.6%. coefficient of bimodality: 0.53; pi z score %26lt; -1: 8%. maternal hypertensive disease was systematically associated with being small for gestational age (aor 1.20, 95% ci 0.86-1.67), fetal growth ratio %26lt; 0.89 (aor 1.71, 1.24-2.36) and pi z score %26lt; -1 (aor 1.60, 1.03-2.41). adjusted odds ratios for neonatal mortality were: 2.64 (95% ci 1.71-3.92) for being small for gestational age, 2.76 (95% ci 1.85-4.10) for fetal growth ratio %26lt; 0.89, and 1.37 (95% ci 0.80-2.32) for z score pi %26lt; -1. conclusions: small for gestational age, mostly symmetric and severe restriction is a frequent condition in %26lt; 1,500 g neonates and is associated with higher mortality rates.
