57: Neonatal Morbidities in Small for Gestational Age Preterm Neonates: Is it Really Double Trouble?
Notice bibliographique
Résumé
Small for gestational age premature (SGA) neonates are an important subset among the preterm population. SGA preterm infants may suffer from complications of both prematurity and intrauterine growth retardation. There is considerable controversy in the literature, with some studies reporting an increase in neonatal mortality and morbidity in SGA premature neonates; while other studies reporting no risk difference. The varying results could be due to use of different growth standards, or inclusion based on liberal birth weight criteria. Given the uncertainty we designed a study, in a well defined sample, with sex specific, valid, population based growth standards, in order to evaluate neonatal morbidities affecting SGA neonates born at less than 31 weeks of gestation. To compare the rate of neonatal morbidities in SGA and AGA neonates born at less than 31 weeks of gestation. This was a hospital based cohort study of infants admitted or transferred into the neonatal intensive care unit at a tertiary referral center in South western Ontario, Canada. All neonates less than 31 weeks of gestation, born between January 1, 2000 to Dec 31, 2012, and who survived till discharge, were identified retrospectively. The neonates were classified as AGA (10th to 90th percentile) or SGA (<10th percentile) as per their birth percentile based on Kramer et al. Infants with major congenital anomalies were excluded. Maternal and neonatal demographic data and data regarding neonatal morbidities such as RDS, BPD, Mechanical Ventilation, PDA, PDA treatment, NEC, IVH, PVL, Sepsis, ROP, treatment for ROP were extracted from the Neonatal Perinatal Database. A total of 923 neonates met the inclusion criteria of which 9.5% were SGA and 87.6% were AGA. As expected maternal PIH rate was higher in the SGA group (51.1%) compared to the AGA group (51.1% vs. 14.0%; P<0.001). A higher proportion of SGA babies were delivered via Cesarean section (89.8% vs. 60.2%; P<0.001). Neonatal morbidities like RDS, BPD, sepsis, NEC, Sepsis, ROP, IVH and PVL were found to be statistically no different in the two groups. Hemodynamically significant PDA was significantly lower in SGA infants (39.8% vs. 53,8%; P=0.01). The need for mechanical ventilation was also found to be lower in SGA infants (68.2% vs. 78.6%; P=0.03). Days on oxygen and number of days to full feed were comparable in the two groups. SGA preterm infants born at less than 31 weeks of gestation were found to have similar rates of neonatal morbidities such as RDS, BPD, NEC, ROP as their AGA peers. SGA infants had lower rates of mechanical ventilation and hemodynamically significant PDA.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».