MORTALITY AND MORBIDITY PATTERN IN SMALL-FORGESTATIONAL AGE AND APPROPRIATE-FOR-GESTATIONAL AGE VERY PRETERM BABIES: A HOSPITAL BASED STUDY
Abstract
Background: Very preterm babies are important group of paediatric babies who require specialattention. These babies are known to have increased risk of morbidity and mortality. Studying the
morbidity and mortality pattern for this important paediatric group can help in better understanding of
their care in the hospital settings. Objective of the study was to compare the mortality and morbidity
pattern in Small-for-gestational age and appropriate-for-gestational age very preterm babies. This
hospital based prospective (cohort) study was conducted at the department of Paediatrics, Postgraduate
Medical Institute, Lady Reading Hospital, Peshawar from March 2008 to April 2009. Methods: One
hundred Small-for-gestational age (SGA) live born very preterm babies were compared with 100
appropriate-for-gestational age (AGA) very preterm babies having similar gestational ages. Information
regarding gestational age, birth weight, mortality, and morbidity (in terms of various biochemical and
clinical markers) were recorded on a pre-designed questionnaire. Data analysis was done using SPSS
version 15. Results were interpreted in terms of descriptive (mean, proportions, standard deviation) and
inferential statistical tests (with p-values). Results: There was no difference between the two groups
(SGA Vs AGA) with regards to gestational age and gender of the babies The mean weight of SGA
babies was significantly lower as compared to AGA babies (1.1±0.16 Kg Vs 1.5±0.2 Kg; p=0.001). As
compared to AGA babies, the SGA babies had a higher mortality (40% Vs 22%, p=0.006), and higher
morbidity in terms of hyperbilirubinaemia (67% Vs 51%, p=0.02) and hypocalcaemia (24% Vs 10%,
p=0.02). The difference in the mortality between the two groups was more prominent in babies with
gestational age ‰¤31 weeks (71.4% for SGA as compared to 39.3 % for AGA very preterm babies with
gestational age ‰¤31 weeks). Conclusion: Very preterm SGA infants have significantly higher mortality
and morbidity in comparison to the AGA babies. In deciding for therapeutic management of these
babies, they need special attention in terms of factors as gestational age and the biochemical markers, to
improve the outcome for these babies in the hospital settings.
Keywords: Very preterm, SGA, AGA, mortality and morbidity
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