Aim: The aim of this study was to investigate the impact of the severity of small-for-gestational-age status on mortality and prematurity-related morbidities in very preterm infants.
Study Design: Data from all inborn very preterm infants (<32 weeks' gestation) were evaluated. Infants with congenital anomalies or those who were large-for-gestational-age were excluded.
Results: Of the 461 infants included, 74 (16%) were classified as small for gestational age (SGA). The rates of culture-proven late-onset sepsis and mortality were higher in the SGA group than in the non-SGA group (p<0.05). However, no significant differences were observed in other prematurity-related morbidities between the groups (p>0.05). The Z-score cut-off value for predicting mortality was –1.68, with a sensitivity of 71.4% and a specificity of 66.7% (area under the curve: 0.696; 95% confidence interval: 0.574–0.819; p=0.005).
Conclusions: SGA infants had higher rates of sepsis and mortality than non-SGA infants. Furthermore, among SGA preterm infants, a lower birth weight Z-score was associated with increased mortality. Careful perinatal follow-up is essential for preterm infants born SGA.