Hernández HR, Flores SR, Martínez-Marrufo AM, Chávez-Cruz O

Language: Spanish
References: 21
Page: 444-448
PDF size: 264.03 Kb.

ABSTRACT

Background. There are few cases of live neonates with intrauterine growth retardation (IGR) ‹500 g with a satisfactory outcome, including apparent normal neurodevelopment.
Clinical case. We report the case of a female 480 g neonate diagnosed with severe IGR who was the product of a 30-year-old mother. This was the first gestation and delivery was at 31 gestation weeks. The neonate demonstrated severe oligoamnios and was delivered by Cesarean section. Apgar score was 7-7, oxygen was administered at 48 h, and parenteral nutrition and formula for premature infants was initiated. Serum cytomegalovirus IgG and IgM and cytomegalic urine inclusion were all negative. The infant accepted formula and was asymptomatic. She reached 500 g at 20 days of life. At 5 months old, her weight increased to 1 700 g before hospital discharge. Patient was followed-up until 1 year of age. She weighed 2.8 kg and demonstrated a 6-month delay in psychomotor neurodevelopment. It is important to mention that she did not develop retinopathy of prematurity, periventricular leukomalacia or intracranial hemorrhage.
Conclusion. The patient presented here was born after 31 weeks gestation with a birth weight of 480 g. She showed severe IGR with neurodevelopmental delay; however, no retinopathy of prematurity, periventricular leukomalacia or intracranial hemorrage was demonstrated.

REFERENCES

1. Jones HP, Karuri S, Cronin CMG, Ohlsson A, Peliowski A, Synnes A, et al. Actuarial survival of a large Canadian cohort of preterm infants. BMC Pediatr 2005;5:40-53.

2. Paul DA, Leef K, Locke RG, Bartoshesky L, Walrath J, Stefano JL. Increasing illness severity in very low birth weight infants over a 9-year period. BMC Pediatr 2006;6:2.

3. Horbar JD, Badger GJ, Carpenter JH, Fanaroff AA, Kilpatrick S, LaCorte M, et al. Trends in mortality and morbidity for very low birth weight infants, 1991-1999. Pediatrics 2002;110:143-151.

4. Fanaroff AA, Wright LL, Stevenson DK, Shankaran S, Donovan EF, Ehrenkranz RA, et al. Very low birthweight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, May 1991 through December 1992. Am J Obstet Gynecol 1995;173:1423-1431.

5. Ferrara TB, Hoekstra RE, Couser RJ, Gaziano EP, Calvin SE, Payne NR, et al. Survival and follow-up of infants born at 23-26 weeks of gestational age: effects of surfactant therapy. J Pediatr 1994;124:119-124.

6. Jobe AH, Mitchell BR, Gunkel JH. Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants. Am J Obstet Gynecol 1993;168:508-513.

7. Corbet A, Bucciarelli R, Goldman S, Mammel M, Wold D, Long W. American Exosurf Pediatric Study Group I. Decreased mortality rate among small premature infants treated at birth with a single dose of synthetic surfactant: a multicenter controlled trial. J Pediatr 1991;118:277-284.

8. Gerlinde MS, Stoelhorst MD, Rijken M, Martens S, Brand R, DenOuden A, et al. Changes in neonatology: comparison of two cohorts of very preterm infants (gestational age <32 weeks): the Project on Preterm and Small for Gestational Age Infants 1983 and the Leiden Follow-Up Project on Prematurity 1996-1997. Pediatrics 2005;115:396-404.

9. Salle B, Picaud JC, Lopilloune A, Claris O. Mortality and morbidity of low-birth-weight infants. Current prognosis and future perspectives. Bull Acad Natl Med 2004;188:1127-1139.

10. Cartlidge PH, Stewart JH. Survival of very low birthweight and very preterm infants in a geographically defined population. Acta Paediatr 1997;86:105-110.

11. Stevens DC, Munson DP, Klinhagen RD, Becker BK. Survival of the tiny neonate: USD School of Medicine/Sioux Valley Hospital experience, 1981-1992. SDJ Med 1994;47:349-353.

12. Tyson JE, Younes N, Verter J, Wright LL. Viability, morbidity, and resource use among newborns of 501- to 800-g birth weight. National Institute of Child Health and Human Development Neonatal Research Network. JAMA 1996;276:1645-1651.

13. Kollée LA. Twenty-five week limit for viability of the foetus is ethically correct. Ned Tijdschr Geneeskd 2005;149:1938.

14. Meadow W, Reimshisel T, Lantos J. Birth weight-specific mortality for extremely low birth weight infants vanishes by four days of life: epidemiology and ethics in the neonatal intensive care unit. Pediatrics 1996;97:636-643.

15. Kamoji VM, Dorling JS, Manktelow BN, Draper ES. Field DJ. Extremely growth-retarded infants: is there a viability centile? Pediatrics 2006;118:758-763.

16. Babson SG. Growth of the low-birth-weight infants. J Pediatr 1970;77:11-18.

17. Marks KH, Maisels MJ, Moore E, Gifford K, Friedman Z. Head growth in sick premature infants-a longitudinal study. J Pediatr 1979;94:282-285.

18. Lucey JF, Rowan CA, Shiono P, Wilkinson AR, Kilpatrick S, Payne NR, et al. Fetal infants: the fate of 4172 infants with birth weights of 401 to 500 grams: the Vermont Oxford Network experience (1996-2000). Pediatrics 2004;113:1559-1566.

19. Fanaroff A, Poole K, Duara S, Goldberg R, Laptook A, Oh W, et al. Micronates: 401-500 grams: the NICHD Neonatal Research Network Experience 1996-2001. Pediatr Res 2003;53:398A.

20. Schollin J. Views on neonatal care of newborns weighing less than 500 grams. Acta Paediatr 2005;94:140-142.

21. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network. Am J Obstet Gynecol 2000;182:198-206.