Objective: This study aimed to compare the short- and long-term outcomes of extremely preterm small-for-gestational-age (SGA) infants and appropriate-for-gestational-age (AGA) infants in Japan. Study design: We retrospectively assessed 434 SGA and 1716 AGA infants born at 22–27 weeks of gestational age (GA), between 2003 and 2012. Infants were followed up for 3 years, and the clinical characteristics and outcomes were compared. Fisher’s exact and Student’s t-tests were used for independent sample comparison. Logistic regression was used to identify associated factors. Results: The prevalence of intraventricular hemorrhage  Grade 3 was significantly lower (adjusted odds ratio (aOR), 0.28; 95% confidence interval (CI), 0.11-0.72), and the prevalence of bronchopulmonary dysplasia at 36 weeks GA and the need for home oxygen therapy, significantly higher (aOR, 2.20; 95% CI, 1.66-2.91 and aOR, 2.46; 95% CI, 1.75-3.47, respectively) in SGA infants than in AGA infants. SGA infants born at > 23 weeks GA had a significantly higher prevalence of developmental quotient (DQ) < 70 (aOR, 1.69; 95% CI, 1.08-2.65). Those born at > 25 weeks GA showed a significantly higher prevalence of cerebral palsy (CP) and visual impairment (aOR, 1.92; 95% CI, 1.09-3.39 and aOR, 2.42; 95% CI, 1.21-4.86, respectively). Conclusions: In SGA infants, birth at GA > 23 weeks is an independent risk factor for DQ < 70, and birth at GA > 25 weeks is an independent risk factor for CP and visual impairment. However, we did not consider nutritional and developmental factors, and a longer follow-up would help assess neurodevelopmental outcomes. Keywords: appropriate-for-gestational-age, bronchopulmonary dysplasia, gestational age, neurodevelopmental impairment, small-for-gestational-age

Received: 04 November 2021

Accepted after revision: 23 August 2022

Accepted Manuscript online:
30 August 2022

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