RESUMO
To determine the effect of intrauterine growth retardation on the outcome of the premature infant, we compared a group of 35 premature, small-for-gestational-age (SGA) infants with two groups of premature, appropriate-for-gestational-age (AGA) infants: one with similar birth weight (AGA-BW group) and the other with similar gestational age (AGA-GA group). Groups were matched by year of birth, race, gender, and socioeconomic status. Infants were free of major congenital anomalies and intrauterine infection. They were evaluated at term, at 20 and 40 weeks, and at 1 year corrected age. The SGA infants had a lower mean developmental quotient than the two groups of AGA infants. The SGA infants had significantly smaller body dimensions at birth, more nursery complications, and a higher incidence of major neurologic problems than their AGA-GA matches but were comparable to the AGA-BW matches. Poor growth constitutes an additional risk factor to prematurity. The results highlight the importance of comparing premature SGA infants with premature AGA infants of similar gestational age rather than similar birth weight.
Assuntos
Peso ao Nascer , Desenvolvimento Infantil , Idade Gestacional , Doenças do Prematuro/etiologia , Recém-Nascido Pequeno para a Idade Gestacional/fisiologia , Dano Encefálico Crônico/etiologia , Feminino , Retardo do Crescimento Fetal/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Testes Neuropsicológicos , Gravidez , Complicações na Gravidez/etiologia , Fatores de RiscoRESUMO
The effect of phototherapy on subsequent growth of low-birth-weight infants has been evaluated at two-year follow-up of infants from two separate controlled neonatal studies. Growth of weight, length, and head circumference in the treated infants of Group I was slower than that of control subjects. Growth was comparable in treated infants and control subjects in Group II, and the two control groups, although not concurrent were also similar. Infants whose heads were growing at a normal rate, even though below 2 SD from the norms, were developing normally. Only infants who had deceleration in rate of head growth were abnormal. It is unlikely that phototherapy was responsible for the slow growth patterns seen in Group I, since these patterns were not reproducible in Group II.
Assuntos
Crescimento , Recém-Nascido de Baixo Peso , Fototerapia , Peso Corporal , Seguimentos , Humanos , Hiperbilirrubinemia/terapia , Recém-NascidoRESUMO
A total of 120 preterm infants were randomly divided at 24 hr of age into three groups: Group I, controls; Group II, continuous phototherapy for 5 days; and Group III, intermittent phototherapy (12 hr on and 12 hr off) for 5 days. At the end of week 1 80% of the control group regained and surpassed their birth weight as opposed to 44 and 57.6% in the continuous and intermittent phototherapy groups, respectively. In weeks 2 and 3 both phototherapy groups had greater weight gain than the control group. Similar but less marked differences were observed in body lenth and head circumference in the three groups. Data suggest decreased growth during phototherapy with subsequent catch-up in growth during weeks 2 and 3. Differences were less marked between infants on intermittent (rather than continuous) phototherapy and controls. Increased metabolic demands and decreased intestinal absorption during phototherapy may be two of the factors responsible for the observed differences in growth in the three groups.