Comparison of AGA and SGA Infants Based on Prooxidant‐to‐Antioxidant Balance in Mashhad, Iran During 2019–2025: A Cross‐Sectional Study

Background and Aims Small for Gestational Age (SGA) infants face numerous challenges that may stem from a prooxidant–antioxidant imbalance. This study aims to compare AGA and SGA infants regarding their PAB (Prooxidant‐Antioxidant Balance) levels. Methods This cross‐sectional study was conducted on 898 neonates, including 798 (88.9%) appropriate for gestational age (AGA) infants and 100 (11.1%) small for gestational age (SGA) infants. The research utilized convenience sampling at Ghaem Hospital in Mashhad, spanning from 2019 to 2025. Data were collected using a questionnaire developed by the researchers, which consisted of three sections: neonatal information (including gestational age, first‐minute Apgar score, fifth‐minute Apgar score, and birth weight) and laboratory information (including umbilical cord pH and neonatal PAB levels). The SGA infants were classified as the case group, while the AGA infants served as the control group. The study compared PAB levels and neonatal outcomes—including asphyxia, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), and sepsis—between the two groups. Results The mean gestational age for the AGA group was 34.29 ± 4.31 weeks, while the mean gestational age for the SGA group was 34.75 ± 2.63 weeks. The 1‐min Apgar score showed significant differences, with a p ‐value of 0.000, and the 5‐min Apgar score also differed significantly between the groups ( p = 0.001), being higher in the SGA group. Additionally, the birth weight was significantly lower in the SGA group ( p = 0.001). The mean neonatal PAB in the SGA group was 1.5 times greater than that of the AGA group ( p = 0.000). When comparing the two groups, the incidence of acute asphyxia ( p = 0.002), retinopathy of prematurity (ROP) ( p = 0.028), intraventricular hemorrhage (IVH) ( p = 0.047), NEC ( p = 0.000), and PDA ( p = 0.049) showed statistically significant differences. Conclusion The current study's results show that PAB levels are higher in SGA infants compared to AGA infants. Additionally, instances of ROP, and NEC were more prevalent in the SGA group.