Full-Term Small-for-Gestational-Age Newborns in the U.S.: Characteristics, Trends, and Morbidity

Details

• Alternative Title:
  Matern Child Health J
• Personal Author:
  Ewing, Alexander C. ; Ellington, Sascha R. ; Shapiro-Mendoza, Carrie K. ; Barfield, Wanda D. ; Kourtis, Athena P.
• Description:
  Objectives
  
  The magnitude, characteristics, and morbidity of term (≥37 weeks gestation) newborns that are small-for-gestational-age (SGA) in the U.S. are underexplored. We sought to examine characteristics and trends for SGA-coded term newborns in the U.S.
  
  Methods
  
  Data were obtained from the Nationwide Inpatient Sample, a nationally representative database of hospital stays in the U.S. from 2002 to 2011. Term, singleton newborns with SGA codes were identified and examined over the study period. Demographic characteristics were compared for term newborns according to presence of SGA codes using χ2 tests. Odds ratios (OR) were calculated to compare morbidities between the two groups, adjusting for relevant demographic and clinical variables.
  
  Results
  
  In 2011, 15 per 1000 term newborns in the U.S. were coded as SGA, a 29.9 % increase since 2002. Compared with other term newborns, SGA term newborns were significantly (p < 0.05) more likely to be female, receive public insurance, and reside in lower income zip codes. Comorbidities, including perinatal complications, metabolic disorders, central nervous system diseases, infection, and neonatal abstinence syndrome were more common among SGA-coded term newborns. These newborns also had higher odds of in-hospital death (OR = 3.0 95 % confidence interval: 2.0, 4.4), longer mean length of stay (3.7 vs. 2.3 days, p <0.001), and higher mean hospital charges ($12,621 vs. $5012, p < 0.001).
  
  Conclusions for practice
  
  Term newborns coded as SGA have higher morbidity, mortality, and incur higher hospital charges than other term newborns. More research is needed to understand causes of SGA so its incidence and effects can be reduced.
  
  
• Keywords:
  Birth Weight Female Healthcare Utilization Humans Incidence Infant Infant, Newborn Infant, Newborn, Diseases Infant, Premature Infant, Small For Gestational Age Infant Mortality Male Maternal And Fetal Medicine Morbidity Neonatology Newborn Infant Odds Ratio Pregnancy Term Birth United States

  More +
• Source:
  Matern Child Health J. 21(4):786-796
• Pubmed ID:
  27502090
• Pubmed Central ID:
  PMC5728417
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  21
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2b1182566b25b68727444eac649dc1aa4744366a490c293a0540bdba13242b50
• Download URL:
  https://stacks.cdc.gov/view/cdc/50537/cdc_50537_DS1.pdf
• File Type:
  [PDF - 652.06 KB ]