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Customised birthweight models: Do they increase identification of at‐risk infants?
Author(s) -
Gibbons Kristen,
Chang Allan,
Flenady Vicki,
Mahomed Kassam,
Gardener Glenn,
Gray Peter H,
Beckmann Michael,
Rossouw Dominique
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12189
Subject(s) - small for gestational age , medicine , population , confidence interval , pediatrics , birth weight , obstetrics , singleton , pregnancy , environmental health , genetics , biology
Aim The study aims to describe the cohort of women and babies who are classified as small‐for‐gestational age ( SGA ) at term by both an Australian customised birthweight model ( CBM ) and a commonly used population‐based standard, and to investigate and compare the utility of these models in identifying babies at risk of experiencing adverse outcomes Methods Routinely collected data on 54 890 singleton‐term births at the M ater M others' H ospitals, B risbane, with birthweight less than 4000 g between J anuary 1997 and D ecember 2008, was extracted. Each birth was classified as SGA (<10th centile) or not SGA by either and/or both methods: population‐based standards (SGA pop ) and CBM ( SGA cust ). Babies classified as SGA pop , SGA cust or SGA both were compared with those not classified as SGA by both methods using relative risk and 95% confidence interval, and those only classified as SGA cust were compared with those only classified as SGA pop . Maternal demographics, maternal risk factors for fetal growth restriction, pregnancy and labour complications and adverse neonatal outcomes are reported. Results A total of 4768 (8.7%) births were classified as SGA pop , while 6479 (11.8%) were SGA cust of whom 4138 (63.9%) were also classified as SGA pop . Maternal risk factors such as smoking and hypertension were statistically higher for the SGA cust group when compared with SGA pop . For the majority of adverse neonatal outcomes, a trend was noted to increased identification using the CBM . Conclusion The CBM provides a modest improvement when compared to a population‐based standard to identity term infants at birth who are at risk of adverse neonatal outcomes.