Small for gestational age very preterm infants present a higher risk of developing bronchopulmonary dysplasia

INTRODUCTION

Several studies assessed the influence of a low birth weight on bronchopulmonary dysplasia (BPD), but not all could find a significant association. Our aim was to assess the association between low birth weight and BPD in preterm infants, prospectively recruited at 11 level III Portuguese neonatal centers.

METHODS

Obstetrical and neonatal data on mothers and preterm infants with gestational ages between 24 and 30 weeks, born during 2015 and 2016 after a surveilled pregnancy, were analyzed. Neonates were considered small for gestational age (SGA) when their birthweight was below the 10th centile of Fenton's growth chats and BPD was defined as the dependency for oxygen therapy until 36 weeks of corrected age. Statistical analysis was performed using IBM SPSS® statistics 23 and a p-value <0.05 was considered statistically significant.

RESULTS

Out of 614, a total of 494 preterm infants delivered from 410 women were enrolled in the study; 40 (8.0%) infants with SGA criteria. SGA were more often associated with a single pregnancy, had greater use of antenatal corticosteroids, increased prevalence of gestational hypertensive disorders, C-section, rupture of membranes below 18 hours, rate of intubation in the delivery room, use of surfactant treatment, oxygen therapy, mechanical ventilation need, BPD, cystic periventricular leukomalacia, nosocomial sepsis and pneumonia; had lower prevalence of chorioamnionitis, and lower Apgar scores. The multivariate analysis by logistic regression, adjusted for BPD risk factors revealed a significant association between SGA and BPD: OR = 5.2 [CI: 1.46-18.58]; p = 0.01.

CONCLUSION

The results of this study increase the scientific evidence that SGA is an independent risk factor for BPD.

[A descriptive study of burn injuries in children and adolescents]

OBJECTIVE: To investigate the frequency of different kinds of burns, associated factors, major complications and their relations to other variables. METHODS: Descriptive study performed at Hospital João XXIII from January to December of 1992 with five hundred and thirtyseven children and adolescents. RESULTS: The age distribution was as follows: 408 patients were children (76%) and 129 were teenagers (24%). Most of the accidents, 398 cases (74%) happened at home, 235 of which (59%) in the kitchen. 80 patients were interned. They had the highest relative frequency of accidents outside home (p<0.05). Of these interned patients, 7 (9.0%) developed septicemia. The flame was the predominant agent within the group of inpatients (p<0.01) and was responsible for the highest extension of burning (p<0.05). Teenagers had the largest body burned surface compared to children (p<0.01). Local treatment with pomade or home made medicine was observed in 290 cases (54%); local wash with water only in 32 (6.0%). Dehydration was the most frequent complication and occurred in 28 (5,0%) patients. The average amount of internment was 30-/+33 days. CONCLUSIONS: Most of burning were consequence of domestic accidents, especially in youngers than 7 years old; hot liquids are the most frequent agents and kitchen the most frequent place. Flame, which determined the largest and deepest lesions, was the first cause of burns in teenagers and the second in children. Dehydration is the most frequent complication in the earlier phases and septicemia in the others.