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Prescriptive birthweight charts can improve the prediction of adverse outcomes in very preterm infants who are small for gestational age
Author(s) -
Hoftiezer Liset,
Snijders Renske G.,
Hukkelhoven Chantal W.P.M.,
Lingen Richard A.,
Hogeveen Marije
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14243
Subject(s) - medicine , small for gestational age , growth chart , gestational age , chart , birth weight , pediatrics , anthropometry , intrauterine growth restriction , low birth weight , obstetrics , retrospective cohort study , cohort , pregnancy , gestation , statistics , genetics , mathematics , biology
Abstract Aim We compared three anthropometric charts to determine which provided the best predictions for adverse outcomes in very preterm small for gestational age (SGA) infants to address a lack of consensus on this subject. Methods This was a retrospective cohort study of infants born below 32 weeks, who were admitted to two‐level three neonatal intensive care units in The Netherlands from 2008 to 2013. The birthweights of 1720 infants were classified as SGA using a conventional, gender‐specific birthweight chart, based on births in The Netherlands between 2000 and 2007, a prescriptive, gender‐specific birthweight chart, based on the same data but without risk factors for intrauterine growth restriction (IUGR), and a non‐gender‐specific foetal weight chart derived from American ultrasonographic measurements. Results The conventional, prescriptive and foetal weight charts classified 126 (7.3%), 494 (28.7%) and 630 (36.6%) infants as SGA . The prescriptive chart, which excluded IUGR, identified 368 SGA infants with significantly increased risks of neonatal mortality and morbidity. The 136 SGA infants just classified by the American foetal weight chart were not at increased risk. Conclusion The prescriptive birthweight chart, which excluded infants with IUGR , was the most effective chart when it came to identifying clinically important risk increases in SGA infants.