MORTALITY AND MORBIDITY PATTERN IN SMALL-FORGESTATIONAL AGE AND APPROPRIATE-FOR-GESTATIONAL AGE VERY PRETERM BABIES: A HOSPITAL BASED STUDY
AbstractBackground: Very preterm babies are important group of paediatric babies who require specialattention. These babies are known to have increased risk of morbidity and mortality. Studying themorbidity and mortality pattern for this important paediatric group can help in better understanding oftheir care in the hospital settings. Objective of the study was to compare the mortality and morbiditypattern in Small-for-gestational age and appropriate–for-gestational age very preterm babies. Thishospital based prospective (cohort) study was conducted at the department of Paediatrics, PostgraduateMedical Institute, Lady Reading Hospital, Peshawar from March 2008 to April 2009. Methods: Onehundred Small-for-gestational age (SGA) live born very preterm babies were compared with 100appropriate-for-gestational age (AGA) very preterm babies having similar gestational ages. Informationregarding gestational age, birth weight, mortality, and morbidity (in terms of various biochemical andclinical markers) were recorded on a pre-designed questionnaire. Data analysis was done using SPSSversion 15. Results were interpreted in terms of descriptive (mean, proportions, standard deviation) andinferential statistical tests (with p-values). Results: There was no difference between the two groups(SGA Vs AGA) with regards to gestational age and gender of the babies The mean weight of SGAbabies was significantly lower as compared to AGA babies (1.1±0.16 Kg Vs 1.5±0.2 Kg; p=0.001). Ascompared to AGA babies, the SGA babies had a higher mortality (40% Vs 22%, p=0.006), and highermorbidity in terms of hyperbilirubinaemia (67% Vs 51%, p=0.02) and hypocalcaemia (24% Vs 10%,p=0.02). The difference in the mortality between the two groups was more prominent in babies withgestational age ≤31 weeks (71.4% for SGA as compared to 39.3 % for AGA very preterm babies withgestational age ≤31 weeks). Conclusion: Very preterm SGA infants have significantly higher mortalityand morbidity in comparison to the AGA babies. In deciding for therapeutic management of thesebabies, they need special attention in terms of factors as gestational age and the biochemical markers, toimprove the outcome for these babies in the hospital settings.Keywords: Very preterm, SGA, AGA, mortality and morbidity
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