Differential classification of infants in United States neonatal intensive care units for weight, length, and head circumference by United States and international growth curves
Differential classification of infants in United States neonatal intensive care units for weight, length, and head circumference by United States and international growth curves
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DOI：
10.1080/03014460.2020.1817555
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发表时间：
2020-09-17
影响因子：
1.7
通讯作者：
Lawson, M. Louise
中科院分区：
文献类型：
--
作者：
Ferguson, A. Nicole;Olsen, Irene E.;Lawson, M. Louise
临床医生和研究人员使用各种宫内生长曲线将NICU婴儿分为小于胎龄儿（SGA）、合适胎龄儿（阿加）和大于胎龄儿（LGA）。由于曲线创建方法和样本各不相同，SGA/阿加/LGA临界值和由此产生的婴儿亚组在曲线之间各不相同，并影响结局研究结果-限制了普遍性。目的确定两个国际和两个美国特定的曲线分类美国新生儿重症监护室婴儿。受试者和方法使用国际芬顿和INTERGROWTH-21曲线以及美国特定的Olsen和Lubchenco（历史）曲线，将来自美国NICU（2013-2016）的192，888名婴儿按出生体重、身长和头围分类为SGA或LGA。结果现代曲线将约10%的婴儿分类为小于32周的SGA，但年龄较大的婴儿变异性增加。32周后，INTERGROWTH-21曲线的LGA发生率始终高于10%。结论：虽然Olsen和芬顿都符合，但Olsen曲线对我们的美国NICU婴儿样本具有总体最佳拟合。INTERGROWTH-21st曲线符合年轻人的SGA和LGA定义，但由于样本量有限，这些定义之外的推断是不必要的。用于33周及更大婴儿的INTERGROWTH-21样本在上腹部的体格小于我们的美国婴儿样本。
Background Clinicians and researchers use a variety of intrauterine growth curves to classify NICU infants as small (SGA), appropriate (AGA), or large for gestational age (LGA). Since curve creation methods and samples vary, SGA/AGA/LGA cut-offs and resulting subgroups of infants vary among curves and impact outcome study findings - limiting generalisability. Aim Determine how two international and two US-specific curves classified US NICU infants. Subjects and methods Classified 192,888 infants from US NICUs (2013-2016) as SGA or LGA for birthweight, length, and head circumference, using the international Fenton and INTERGROWTH-21st curves and US-specific Olsen and Lubchenco (historical) curves. Results Modern curves classified approximately 10% of infants as SGA up to 32 weeks, but older infants had increased variability. The INTERGROWTH-21st curves consistently had rates above 10% for LGA after 32 weeks. Conclusions While Olsen and Fenton both fit, the Olsen curves had overall best-fit for our sample of US NICU infants. The INTERGROWTH-21st curves fit the definitions for SGA and LGA for younger ages, but inferences outside of these definitions are unwarranted due to limited sample size. The INTERGROWTH-21st sample used for 33 weeks and older infants was physically smaller at the upper percentiles than our sample of US infants.