Document Detail


Conventional birth weight standards obscure fetal growth restriction in preterm infants.
MedLine Citation:
PMID:  16547077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: It has been suggested that fetal growth restriction (FGR) is associated with fetal maturation so that, compared with appropriately grown preterm infants, mortality and some neonatal morbidities may be reduced. The evidence for this is conflicting, and severe FGR has been shown to be harmful. In addition excessive growth has also been shown to be associated with poorer outcomes. As preterm infants are often also growth restricted, centiles for birth weights are distorted and may conceal the degree of growth restriction in a given infant. This study investigated whether using estimated fetal weights (EFW) might reveal the effects of hidden FGR.
POPULATION AND METHODS: Using a 25-year database of preterm admissions to a single neonatal unit the ORs for mortality and neonatal morbidities for z scores for birth weight above and below the mean were computed and compared with those computed for z scores for EFW.
RESULTS: In 7898 infants born at less than 35 weeks' gestation, the OR for mortality was lowest for birth weights between 1 SD and 3 SD above the mean, but was lowest for EFW between -2 SD and 0 SD below the mean. For periventricular haemorrhage, increasing FGR below the mean reduced the OR with both birth weight and EFW. Apparent reductions in OR for septicaemia, chronic lung disease, persistent ductus arteriosus and necrotising enterocolitis with birth weights of >1 SD above the mean were not seen with EFW. FGR of >-3 SD was associated with increased OR for necrotising enterocolitis with both birth weight and EFW.
CONCLUSION: Using fetal growth rather than birth weight standards gives a better indication of the incidence and role of FGR in neonatal disease.
Authors:
Richard W I Cooke
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Publication Detail:
Type:  Journal Article     Date:  2006-03-17
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  92     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-23     Completed Date:  2007-05-22     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F189-92     Citation Subset:  AIM; IM    
Affiliation:
School of Reproductive and Developmental Medicine, University of Liverpool, Neonatal Unit, Liverpool Women's Hospital, Liverpool L8 7SS, UK. mc19@liv.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Birth Weight / physiology*
Female
Fetal Development / physiology*
Fetal Growth Retardation / diagnosis*
Fetal Weight / physiology
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Male
Pregnancy
Prenatal Diagnosis / standards
Prognosis
Reference Standards
Comments/Corrections
Comment In:
Arch Dis Child Fetal Neonatal Ed. 2007 May;92(3):F161-2   [PMID:  17449851 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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