Abstract
Background: Fetal monitoring may prolong pregnancies with fetal growth restriction [FGR]. Infants with extreme prematurity and FGR may have elevated nucleated red blood cells [NRBC] and negative tests for isoimmunization [termed non-immune erythroblastosis or NIE].
Objective: This study correlated the magnitude of NIE in infants <29 wk of gestation with jaundice at <24 h of age, low platelet counts, intracranial hemorrhage [ICH], hypoglycemia, blood potassium at <72 h of age, cardiomyopathy, pulmonary hypertension, delayed passage of meconium, feeding intolerance, and necrotizing enterocolitis [NEC].
Design/Methods: A case-control, retrospective study examined admissions to a University NICU. Multivariate analysis determined differences between groups. The Holm sequential Bonferroni approach controlled for type I error across tests.
Results: There were 18 cases with FGR. The FGR + NIE group had a lower birth weight (P<.001) and elevated NRBC counts (P<.001) compared to gestational age matched controls. FGR compared to control had a higher occurrence of feeding intolerance [P = .007], ICH [P = .02], and NEC [P = .07]. Odds ratios were 3.4, 4.0, 7.0, and 8.1 for intestinal perforation, NEC, feeding intolerance, and ICH, respectively, in the extremely preterm infants with FGR + NIE v. control.
Conclusions: Extremely preterm infants with FGR and NIE have an increased prevalence of certain neonatal complications compared to normally grown, yet extremely preterm infants without NIE. NIE is a marker for identifying risks of certain conditions in extremely preterm and growth restricted infants.
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Sherman, M., Ghorishi, Z. & Sherman, J. 343 Extreme Prematurity, Fetal Growth Restriction, and Non-Immune Erythroblastosis. Pediatr Res 58, 413 (2005). https://doi.org/10.1203/00006450-200508000-00372
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DOI: https://doi.org/10.1203/00006450-200508000-00372