162 - Association of Neonatal Outcome with Birth Weight for Gestational Age in Chinese Very Preterm Infants: A Retrospective Cohort Study

Poster Number: 162
Publication Number: 162.233

Liangliang Li, Affiliated Hospital of Qingdao University, QingDao, Shandong, China (People's Republic); Jing Guo, Henan Children's Hospital Zhengzhou Children's Hospital, zhengzhou, Henan, China (People's Republic); Yanchen Wang, Children‘s Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Xing Feng, Children' Hospital of Soochow university, Suzhou, Jiangsu, China (People's Republic); chao chen, Children`s Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Yun Cao, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Jianhua Sun, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China (People's Republic); hong Jiang, Affiliated Hospital of Qingdao University, QingDao, Shandong, China (People's Republic); Wenqing Kang, Children’s Hospital of Zhengzhou university, Zhengzhou, Henan, China (People's Republic)

Background: Studies on the association between birth weight (BW) for gestational age (GA) and neonatal outcomes in Chinese neonatal intensive care units (NICU) are lacking.

Objective: To assess the neonatal outcomes across different percentile of BW for GA in China.

Design/Methods: This retrospective cohort study was conducted in 57 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 25 provinces throughout China. Infants with GA 240-316 weeks who were admitted within 7 days after birth were included, between January 1 and December 31, 2019. Infants were excluded if they had major congenital anomalies and ambiguous sex. Composite outcome was defined as mortality and/or any one of neonatal major morbidities, including necrotizing enterocolitis (NEC, Bell’s stage 2 or above), bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH, degree 3 or above), cystic periventricular leukomalacia (cPVL), severe retinopathy of prematurity (ROP, stage 3 or above) and sepsis. BW were converted to age-specific and gender-specific percentiles using the 2013 Fenton growth curve. Multivariable logistic regressions using generalized estimating equation approach were conducted.

Results: A total of 8380 infants were included and the median GA was 30 (28-31) weeks. 1373 (16.5%) infants were born at GA less than 28 weeks while 6997 (83.5%) infants were born at 28 to 31 weeks’ GA. The average of BW was 1329.81 ± 319.50 g. The incidences of composite outcome reduced markedly among groups from 64% at small for gestational age to 39.4% at large for gestational age. The adjusted odds ratios (aOR) of composite outcome also reduced along with increased BW percentile. The aOR and 95% confidence interval of mortality, NEC, BPD, severe ROP and sepsis in infants with BW less than 10% percentile were 5.02 (3.67-6.86), 1.92 (1.32,2.80), 5.64 (4.01,7.92), 5.37 (2.88-9.99) and 1.75 (1.08,2.84) respectively.Conclusion(s): Compared to infants with BW at 50% to 70% percentile, infants with BW less than 30% percentile had higher incidence of composite outcome. There is an urgent need to pay more attention to the infants with body weight less than 30% percentile.
Study Population
Neonatal outcome in each birth weight-for-gestational age