Methods
The purpose of this study was to comparatively evaluate the neonatal evolution and the rate of short-term neonatal complications of the preterm infants with normal weight for the gestational age and of the preterm infants with low weight for the gestational age, as well as of the term infants small for gestational age (SGA). We carried out a retrospective study using the database of the neonates of the Neonatology Clinic of the Bucharest Emergency University Hospital, hospital with a third degree maternity ward, for a period of 3 years. The cases of preterm birth were selected according to the World Health Organization (WHO) definition of birth before 37 full weeks of gestation. Only live newborn cases were selected and analyzed. The cases of premature newborns were classified in two categories according to the birth weight, namely with appropriate weight for the gestational age, named group 1 and including 78 cases and with low weight according to the gestational age corresponding to the international growth curves, named group 2 and including 1121 case. Therefore, the low weight cases selected were those in which the weight at birth was below the two standard deviations of the growth curves corresponding to the gestational age. There were also cases of babies with low birth weight born at term who were selected for the purpose of comparative analysis of their neonatal prognosis (group 3 including 206 cases). The parameters that were analyzed included gestational weight and age as directional criteria, fetal sex, mode of birth (cesarean or spontaneous birth), and Apgar index at 1 minute as a marker of immediate postnatal fetal status. Meanwhile, the obstetric features analyzed included fetal presentation, the spectrum of the spectrum of hypertensive disorders of pregnancy, fetal malformations, nuchal cord and true umbilical cord knot. The immediate neonatal complications and neonatal markers analyzed included: cardio-vascular arrest, acute respiratory failure, ulcer-necrotic enterocolitis, hypoxia, respiratory distress, cerebral edema, intraventricular hemorrhage, cerebral hemorrhage, pulmonary hemorrhage, patent ductus arteriosus, neonatal hypoglycemia, retinopathy, anemia, hemorrhagic disease, disseminated vascular coagulation, hyaline membrane disease, neonatal sepsis, need for neonatal intensive care, and death. A total of 1405 subjects were analyzed and were divided into 3 study groups: group 1 representing live, preterm infants with low weight for gestational age; group 2 representing living newborns, premature but with weight corresponding to the gestational age; and group representing term newborns with low birth weight. The cumulative and comparative analysis by frequency and sex were analyzed in the first phase, following the cumulative and comparative analysis of all the neonatal and obstetrical parameters of the cases in the 3 groups and the statistical analysis regarding the significant difference, or the frequency of the complications analyzed, in those 3 study groups through the chi-square test. The results were analyzed and interpreted according to the obtained P value; P <0.05 was considered to be statistically significant.
The data collected retrospectively did not contain personal information and only the ethics committee agreement of the University Emergency Hospital of Bucharest was required and obtained without the need of informed consent or the consent of the patient/legal representative in the case of minors.