Idioma:

From population reference to national standard: new and improved birthweight charts

Hoftiezer, Liset ; Hof, Michel H.P. ; Dijs-Elsinga, Joyce ; Hogeveen, Marije ; Hukkelhoven, Chantal W.P.M. ; van Lingen, Richard A.

American journal of obstetrics and gynecology, 2019-04, Vol.220 (4), p.383.e1-383.e17 [Periódico revisado por pares]

United States: Elsevier Inc

Texto completo disponível

Citações Citado por

Enviar para

Título:
From population reference to national standard: new and improved birthweight charts
Autor: Hoftiezer, Liset ; Hof, Michel H.P. ; Dijs-Elsinga, Joyce ; Hogeveen, Marije ; Hukkelhoven, Chantal W.P.M. ; van Lingen, Richard A.
Assuntos: Adolescent ; Adult ; Birth Weight ; birthweight ; Congenital Abnormalities - epidemiology ; Cross-Sectional Studies ; Diabetes, Gestational - epidemiology ; Female ; Fetal Development ; fetal growth ; Fetal Growth Retardation - epidemiology ; Gestational Age ; Growth Charts ; Humans ; Hypertension - epidemiology ; Hypertension, Pregnancy-Induced - epidemiology ; Infant, Newborn ; Infant, Small for Gestational Age ; intrauterine growth restriction ; Netherlands - epidemiology ; Pregnancy ; Pregnancy Complications - epidemiology ; Pregnancy Complications, Cardiovascular - epidemiology ; Pregnancy in Diabetics - epidemiology ; Pregnancy, Multiple ; reference charts ; Reference Values ; Retrospective Studies ; risk factors ; small-for-gestational-age ; Substance-Related Disorders - epidemiology ; Young Adult
É parte de: American journal of obstetrics and gynecology, 2019-04, Vol.220 (4), p.383.e1-383.e17
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: Antenatal detection of intrauterine growth restriction remains a major obstetrical challenge, with the majority of cases not detected before birth. In these infants with undetected intrauterine growth restriction, the diagnosis must be made after birth. Clinicians use birthweight charts to identify infants as small-for-gestational-age if their birthweights are below a predefined threshold for gestational age. The choice of birthweight chart strongly affects the classification of small-for-gestational-age infants and has an impact on both research findings and clinical practice. Despite extensive literature on pathological risk factors associated with small-for-gestational-age, controversy exists regarding the exclusion of affected infants from a reference population. This study aims to identify pathological risk factors for abnormal fetal growth, to quantify their effects, and to use these findings to calculate prescriptive birthweight charts for the Dutch population. We performed a retrospective cross-sectional study, using routinely collected data of 2,712,301 infants born in The Netherlands between 2000 and 2014. Risk factors for abnormal fetal growth were identified and categorized in 7 groups: multiple gestation, hypertensive disorders, diabetes, other pre-existing maternal medical conditions, maternal substance (ab)use, medical conditions related to the pregnancy, and congenital malformations. The effects of these risk factors on mean birthweight were assessed using linear regression. Prescriptive birthweight charts were derived from live-born singleton infants, born to ostensibly healthy mothers after uncomplicated pregnancies and spontaneous onset of labor. The Box-Cox-t distribution was used to model birthweight and to calculate sex-specific percentiles. The new charts were compared to various existing birthweight and fetal-weight charts. We excluded 111,621 infants because of missing data on birthweight, gestational age or sex, stillbirth, or a gestational age not between 23 and 42 weeks. Of the 2,599,640 potentially eligible infants, 969,552 (37.3%) had 1 or more risk factors for abnormal fetal growth and were subsequently excluded. Large absolute differences were observed between the mean birthweights of infants with and without these risk factors, with different patterns for term and preterm infants. The final low-risk population consisted of 1,629,776 live-born singleton infants (50.9% male), from which sex-specific percentiles were calculated. Median and 10th percentiles closely approximated fetal-weight charts but consistently exceeded existing birthweight charts. Excluding risk factors that cause lower birthweights results in prescriptive birthweight charts that are more akin to fetal-weight charts, enabling proper discrimination between normal and abnormal birthweight. This proof of concept can be applied to other populations.
Editor: United States: Elsevier Inc
Idioma: Inglês

Links

View this record in MEDLINE/PubMed

Voltar para lista de resultados

Anterior Resultado 8 Avançar Ir para próxima página

Realização: Logos de Redes Sociais:

From population reference to national standard: new and improved birthweight charts

Hoftiezer, Liset ; Hof, Michel H.P. ; Dijs-Elsinga, Joyce ; Hogeveen, Marije ; Hukkelhoven, Chantal W.P.M. ; van Lingen, Richard A.

United States: Elsevier Inc

Buscando em bases de dados remotas. Favor aguardar.