Analysis Of High-risk Factors And Clinical Complications Of Preterm Small For Gestational Age

Objective:To investigate the differences in high-risk factors and clinical complications among preterm small for gestational age and preterm appropriate for gestational age,and to provide a reference for the prevention of intrauterine growth retardation and postnatal complications in preterm small for gestational age.Methods:All cases of preterm small for gestational age infants born at ≤35 weeks and hospitalized in the neonatal intensive care unit after delivery in the obstetrics department of the First Hospital of Jilin University between 2018 and 2020 were collected,and preterm appropriate for gestational age infants were matched by 1:4according to gestational age.47 cases of preterm SGA and 188 cases of preterm AGA were finally selected according to the inclusion and exclusion criteria.The clinical records of the collected cases were retrospectively analyzed,including 1-minute and5-minute Apgar scores,days of hospitalization,history of intrauterine distress,amniotic fluid,placenta and umbilical cord status,maternal pregnancy history,initiation time of feeding and feeding tolerance,and combined neonatal asphyxia,respiratory distress syndrome(RDS),transient tachypnea of newborn,intracranial hemorrhage,intrauterine infection,neonatal sepsis/infection,neonatal necrotizing enterocolitis(NEC),bronchopulmonary dysplasia(BPD),retinopathy of prematurity(ROP),and the collection of the first postnatal blood gas analysis and blood routine results.To compare whether the differences in general information,prenatal high-risk factors and clinical complications between the two groups of preterm infants were statistically significant.Results:1.There were significant differences between the two groups in 1-minute and5-minute Apgar scores,initiation time of feeding,days of hospitalization,net kilogram weight gain,hemoglobin,platelet,blood glucose and serum calcium levels.2.Placental abnormality,low amniotic fluid volume and maternal hypertension are independent risk factors for preterm SGA.3.There were significant differences in premature rupture of membranes,neonatal asphyxia,feeding intolerance and infection between the two groups(P <0.05).There was no significant difference in RDS,transient tachypnea of newborn,intracranial hemorrhage,intrauterine infection,NEC,ROP,BPD and the respiratory support.Conclusion:1.Maternal hypertension and placental abnormalities are independent risk factors for preterm small for gestational age infants.Amniotic fluid reduction is significantly correlated with preterm small for gestational age infants.2.Preterm SGA infants have lower Apgar scores at 1 minute and 5 minutes,longer time to initiation of feeding and days of hospitalization,and were more likely to have higher hemoglobin level,thrombocytopenia,lower calcium level and glucose level.There is an increased chance of combined neonatal asphyxia,feeding intolerance and sepsis.