Macrosomic births in the United States: Determinants, outcomes, and proposed grades of risk
Macrosomic births in the United States: Determinants, outcomes, and proposed grades of risk
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DOI：
10.1067/mob.2003.302
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发表时间：
2003-05-01
影响因子：
9.8
通讯作者：
Pass, M
中科院分区：
文献类型：
--
作者：
Boulet, SL;Alexander, GR;Pass, M
目的：我们描述巨大儿的产妇危险因素，并评估出生体重类别，以确定不良结局的预测阈值。研究设计：我们分析了1995年至1997年美国的活产和婴儿死亡队列文件，使用选定的期限（37-44周妊娠）美国居民母亲的单活产。我们比较了巨体婴儿（4000-4499克、4500-4999克和5000克左右的婴儿）和体重3000 - 3999克的正常婴儿对照组。结果：产妇发生巨大儿的危险因素包括不吸烟、高龄、已婚、糖尿病、高血压、既往有过大儿或流产史。分娩并发症、出生损伤和新生儿发病率的风险随着新生儿体重的增加而增加。体重50 000克的婴儿死亡率显著增加。结论：虽然将巨大儿定义为>4000 g（1级）可能有助于识别分娩和新生儿并发症的风险增加，但>4500 g（2级）可能更能预测新生儿发病率，>5000 g（3级）可能是婴儿死亡风险的更好指标。
OBJECTIVE: We describe maternal risk factors for macrosomia and assess birth weight categories to determine predictive thresholds of adverse outcomes.STUDY DESIGN: We analyzed linked live birth and infant death cohort files from 1995 to 1997 for the United States with the use of selected term (37-44 weeks of gestation) single live births to mothers who were US residents. We compared macrosomic infants (4000-4499 g, 4500-4999 g, and >5000 g infants) with a normosomic control group of infants who weighed 3000 to 3999 g.RESULTS: Maternal risk factors for macrosomia included nonsmoking, advanced age, married, diabetes mellitus, hypertension, and previous macrosomic infant or pregnancy loss. The risks of labor complications, birth injuries, and newborn morbidity rose with each gradation of macrosomic birth weight. Infant mortality rates increased significantly among infants weighing >5000 g.CONCLUSION: Although a definition of macrosomia as >4000 g (grade 1) may be useful for the identification of increased risks of labor and newborn complications, >4500 g (grade 2) may be more predictive of neonatal morbidity, and >5000 g (grade 3) may be a better indicator of infant mortality risk.