Kenji Ichinomiya, Kenichi Maruyama, Aya Koizumi, Kazuyo Fukuda, Yu Yamazaki, Kota Kaburagi, Haruna Honma
OBJECTIVE: To examine the influence of the severe small for gestational age (sSGA) on long-term outcomes in extremely preterm infants. METHOD: We conducted a retrospective study of infants born < 28 weeks of gestation admitted to Gunma Children’s Medical Center between 2006 and 2014, who either died or had follow-up data available at 3 years of age. Mortality rates, physical growth rates, and neurodevelopmental outcomes were compared between appropriate for gestational age (AGA) and sSGA infants. RESULT: In a comparison of 191 AGA infants and 21 sSGA infants, the mortality rate was not significantly different between the groups (12 [6.3%] AGA vs. 2 [9.5%] sSGA, P = 0.635). Among infants who were evaluated at 3 years of age, sSGA infants had lower mean standard deviation scores for weight in univariate analyses (-0.99 vs. -2.08, P < 0.001). After adjusting for gestational age and sex, sSGA infants had higher rates of neurodevelopmental impairment (adjusted odds ratio (OR): 4.54, 95% confidence interval (CI): 1.43 to 14.4, P = 0.010) or had lower mean standard deviation scores for height (adjusted mean difference: - 0.63, 95% CI: -1.23 to -0.03, P = 0.041) and weight (adjusted mean difference: -1.25, 95% CI: -1.87 to -0.63, P < 0.001) in comparison to AGA infants. CONCLUSION: Although not associated with mortality rates, sSGA infants born extremely preterm had an independent increased risk of neurodevelopmental impairment and physical growth at 3 years of age in contrast to AGA infants.