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  • Title: Retarded fetal growth patterns and early neonatal mortality in a Mexico City population.
    Author: Balcazar H, Haas JD.
    Journal: Bull Pan Am Health Organ; 1991; 25(1):55-63. PubMed ID: 2054553.
    Abstract:
    The study reported here classified 9,660 newborn infants delivered at a maternal and child health center in Mexico City by length of gestation, presence or absence of growth retardation, and (in the case of growth-retarded infants) proportionate or disproportionate growth retardation in terms of the infants' weight and length. It was found that preterm infants (delivered before 38 weeks of gestation) had nine times the early neonatal mortality of term infants, irrespective of growth retardation patterns. Also, the type of fetal growth retardation involved (proportionate or disproportionate) in those cases where such retardation was present was found to have an impact on early neonatal mortality. That is, preterm and term infants classified as having proportionate growth retardation respectively exhibited 1.5 and 9.5 times the early neonatal mortality of preterm and term infants with disproportionate growth retardation. Among other things, these findings suggest a need for assessing types of growth retardation as well as etiologic factors when evaluating mortality risk in newborns. Researchers used 1981-1983 data on 9660 infants born at the Maximino Avila Camacho Maternal and Child Health Center in Mexico City, Mexico to examine the relationship between early neonatal mortality (mortality in the 1st 3 days of life) and various retarded fetal growth patterns. Overall early neonatal mortality rate (ENMR) stood at 7.9/1000 live births. ENMR for premature infants was 37 and that of full term infants was 4.1 ENMR for all small for gestational age (SGA) infants (10th percentile by body weight according to US reference population) was 25.2 compared to 6 for adequate for gestational age (AGA) infants. Premature SGA infants had a significantly higher ENMR than all other groups (p.05; 161.7 vs. 14.7 full term SGA infants, 29 premature AGA infants, and 2.8 for AGA infants). Moreover premature and full term SGA infants had 58 and 5 times respectively the relative risk of early death than full term AGA infants. Full term SGA infants had a lower ENMR than did all premature infants (14.7 vs. 37). Further the ENMR for proportionately growth retarded full term SGA infants (10th percentile by crown heel) was 72.9 compared to 7.6 for the disproportionately growth retarded full term SGA infants (10th percentile by crown heel). The ENMRs for premature proportionate and disproportionate SGA infants were 74.3 and 48.6 respectively. Premature disproportionate SGA infants experienced the highest ENMR (208.3), but the full term disproportionate SGA infants experienced the lowest of any group with intrauterine growth retardation (7.6). In conclusion, the researchers pointed out the need to assess types of growth retardation and etiologic factors when determining mortality risk in neonates.
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