SGA as a Risk Factor for Cerebral Palsy in Moderate to Late Preterm Infants: a System Review and Meta-analysis

Small for gestational age (SGA) is an established risk factor for cerebral palsy (CP) in term infants. However, there is conflicting data on the association between SGA and CP in moderate to late preterm infants. The aim of the article was to explore the relationship between SGA and CP in the moderate to late preterm infants and its strength by meta-analysis. We performed a system search in OVID (EMBASE and MEDLINE) and WANFANG from inception to May 2016. The study-specific risk estimates were pooled using the random-effect model. A total of seven studies were included in the meta-analysis, consisting of three cohort and four case-control studies. A statistically significant association was found between SGA and CP in moderate to late premature infants (OR: 2.34; 95% CI: 1.43-3.82). The association were higher in the several subgroups: 34-36 week gestational age (OR: 3.47; 95% CI: 1.29-9.31), SGA < 2SDs (OR: 3.48; 95% CI: 1.86-6.49), and malformation included in CP (OR: 3.00; 95% CI: 1.71-5.26). In moderate to late premature infants, SGA is a convenient and reliable predictor for CP. More studies are needed to explore the underlying mechanisms between SGA and CP association.