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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

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Source Normalized Impact per Paper (SNIP) 2018: 0.602

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1619-3997
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Volume 35, Issue 5

Issues

Impact of being small-for-gestational age on survival and long-term outcome of extremely premature infants born at 23–27 weeks' gestation

Yumi Kono
  • 1Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Jun Mishina
  • 2Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Tomoko Takamura
  • 3Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Hitoshi Hara
  • 4Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Izumi Sakuma
  • 5Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Satoshi Kusuda
  • 6Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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/ Hiroshi Nishida
  • 7Maternal and Perinatal Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Published Online: 2007-08-09 | DOI: https://doi.org/10.1515/JPM.2007.098

Abstract

Aim: To evaluate factors affecting survival and long-term outcome of extremely premature infants and to determine whether small for gestational age (SGA) status is an additional risk factor.

Methods: Survival was analyzed in 193 infants born between 23 and 27 weeks of gestational age (GA) and compared between SGA (n=43) and appropriate for gestational age (AGA) infants. Long-term outcome was assessed in 123 infants at six years of chronological age by neurological evaluation and cognitive tests.

Results: The long-term survival rates were 72.1% for SGA and 84.0% for AGA infants. Significant independent factors affecting survival were GA (OR 1.79 for one week advance, 95% CI 1.36–2.34) and SGA (OR 0.42, 95% CI 0.18–0.997) in comparison with AGA. There were no significant differences in rates of cerebral palsy or mental retardation, 12.0% and 24.0% in SGA, 14.3% and 17.3% in AGA, respectively. Fifty-two percent of SGA and 70% of AGA infants had intact long-term outcome. The perinatal factor found to affect the intact long-term outcome was RDS with surfactant therapy (OR 0.17, 95% CI 0.07–0.45).

Conclusion: SGA status as well as short gestation had significant effects on survival. Respiratory complications after birth had a larger detrimental effect on long-term outcome than whether the infant was SGA or AGA.

Keywords: Extremely premature; long-term outcome; small for gestational age (SGA)

About the article

Corresponding author: Yumi Kono, MD Maternal and Perinatal Center School of Medicine Tokyo Women's Medical University 8-1 Kawada-cho Shinjuku-ku Tokyo 162-8666 Japan Tel.: +81-3-3341-9538 Fax: +81-3-3341-9538


Received: 2006-12-15

Revised: 2007-04-25

Accepted: 2007-07-04

Published Online: 2007-08-09

Published in Print: 2007-10-01


Citation Information: Journal of Perinatal Medicine, Volume 35, Issue 5, Pages 447–454, ISSN (Online) 16193997, ISSN (Print) 03005577, DOI: https://doi.org/10.1515/JPM.2007.098.

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