Arch Dis Child Fetal Neonatal Ed 94:F363-F367 doi:10.1136/adc.2009.157800
  • Original article

Neonatal mortality and morbidity in extremely preterm small for gestational age infants: a population based study

  1. S H Westby Wold1,
  2. K Sommerfelt1,2,
  3. H Reigstad2,
  4. A Rønnestad3,
  5. S Medbø4,
  6. T Farstad5,
  7. P I Kaaresen6,
  8. R Støen7,
  9. K T Leversen1,2,
  10. L M Irgens8,
  11. T Markestad1,2
  1. 1
    Department of Clinical Medicine, University of Bergen, Bergen, Norway
  2. 2
    Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
  3. 3
    Department of Pediatrics, Rikshospitalet University Hospital, Oslo, Norway
  4. 4
    Department of Pediatrics, Ullevål University Hospital, Oslo, Norway
  5. 5
    Department of Pediatrics, Akershus University Hospital, Lørenskog, Norway
  6. 6
    Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway
  7. 7
    Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway
  8. 8
    Medical Birth Registry of Norway, Locus of Registry-Based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
  1. Correspondence to S H Westby Wold, Department of Pediatrics, Barneklinikken, 5021 Haukeland University Hospital, Bergen, Norway; helenwold{at}
  • Accepted 27 April 2009
  • Published Online First 12 May 2009


Aim: To assess if growth restricted (small for gestational age, SGA) extremely preterm infants have excess neonatal mortality and morbidity.

Methods: This was a cohort study of all infants born alive at 22–27 weeks’ post menstrual age in Norway during 1999–2000. Outcomes were compared between those who were SGA, defined as a birth weight less than the fifth percentile for post menstrual age, and those who had weights at or above the fifth percentile.

Results: Of 365 infants with a post menstrual age of <28 weeks, 31 (8%) were SGA. Among infants with a post menstrual age of <28 weeks, only chronic lung disease was associated with SGA status (OR 2.7, 95% CI 1.0 to 7.2). SGA infants with a post menstrual age of 26–27 weeks had excess neonatal mortality (OR 3.8, 95% CI 1.3 to 11), chronic lung disease and a significantly higher mean number of days (age) before tolerating full enteral nutrition. SGA infants with a post menstrual age of 22–25 weeks had an excess risk of necrotising enterocolitis.

Conclusion: Extremely preterm SGA infants had excess neonatal mortality and morbidity in terms of necrotising enterocolitis and chronic lung disease.


  • Funding The study was funded by the Norwegian Foundation for Health and Rehabilitation through The Unexpected Child Death Society of Norway, the Research Council of Norway and Helse Vest Hospital Trust.

  • Competing interests None.

  • Ethics approval The study was approved by the Regional Committee on Medical Research Ethics and the Norwegian Data Inspectorate.

  • Patient consent Parental consent obtained.

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