Impact of being large-for-gestational-age on neonatal mortality and morbidities in extremely premature infants

Background Small for gestational age (SGA) infants have an increased risk for neonatal mortality and morbidities. However, few studies have examined the risk of large for gestational age (LGA) on these factors. We compared the risk of mortality and morbidities in LGA premature infants with those of appropriate for gestational age (AGA) infants. Methods Premature infants who were born between 2003 and 2012 at Results From 6898 extremely premature infants, 357 (5.2%), 5530 (80.2%), and 1011 (14.7%) were LGA, AGA, and SGA, respectively. A total of 5887 infants (5530 AGA and 357 LGA) were examined after excluding infants with congenital anomalies, unknown sex, and deficient data. The risk of mortality in LGA and AGA infants did not differ (relative risk (95% confidence interval) 1.04 (0.83-1.32)). Compared to AGA infants, LGA infants did not increase the risk of morbidities, including intraventricular hemorrhage, cystic periventricular leukomalacia, treated retinopathy of prematurity, necrotizing enterocolitis, and bronchopulmonary dysplasia. Conclusions This study demonstrates that being born LGA does not correlate with an increased risk of mortality and morbidities in extremely premature infants. Impact It is currently unknown if being large for gestational age is a risk for neonatal morbidity. A total of 6898 preterm infants born It was found that being large for gestational age was not related to increased risk of mortality and morbidities.