In-Hospital Outcomes in Large for Gestational Age Infants at 22-29 Weeks of Gestation

Nansi S Boghossian; Marco Geraci; Erika M Edwards; Jeffrey D Horbar

doi:10.1016/j.jpeds.2018.02.042

In-Hospital Outcomes in Large for Gestational Age Infants at 22-29 Weeks of Gestation

J Pediatr. 2018 Jul:198:174-180.e13. doi: 10.1016/j.jpeds.2018.02.042. Epub 2018 Apr 7.

Authors

Nansi S Boghossian¹, Marco Geraci², Erika M Edwards³, Jeffrey D Horbar⁴

Affiliations

¹ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: nboghoss@mailbox.sc.edu.
² Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
³ Vermont Oxford Network, Burlington, VT; Department of Mathematics and Statistics, University of Vermont, Burlington, VT; Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT.
⁴ Vermont Oxford Network, Burlington, VT; Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT.

PMID: 29631772
DOI: 10.1016/j.jpeds.2018.02.042

Abstract

Objective: To estimate the risks of mortality and morbidities in large for gestational age (LGA) infants relative to appropriate for gestational age infants born at 22-29 weeks of gestation.

Study design: Data on 156 587 infants were collected between 2006 and 2014 in 852 US centers participating in the Vermont Oxford Network. We defined LGA as sex-specific birth weight above the 90th centile for gestational age measured in days. Generalized additive models with smoothing splines on gestational age by LGA status were fitted on mortality and morbidity outcomes to estimate adjusted relative risks and their 95% CIs.

Results: Compared with appropriate for gestational age infants, being born LGA was associated with decreased risks of mortality, respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. Early onset sepsis and severe intraventricular hemorrhage were increased among LGA infants, but these risks were not homogeneous across the gestational age range.

Conclusions: Being born LGA was associated with lower risks for all the examined outcomes except for early onset sepsis and severe intraventricular hemorrhage.

Keywords: anthropometric charts; birth weight for gestational age; extremely preterm infants; morbidity; mortality.

MeSH terms

Birth Weight*
Female
Gestational Age*
Hospital Mortality
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / mortality*
Male
Retrospective Studies