Maternal and pathological pregnancy characteristics in customised birthweight centiles and identification of at-risk small-for-gestational-age infants: a retrospective cohort study
Maternal and pathological pregnancy characteristics in customised birthweight centiles and identification of at-risk small-for-gestational-age infants: a retrospective cohort study
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DOI：
10.1111/j.1471-0528.2012.03313.x
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发表时间：
2012-06-01
影响因子：
5.8
通讯作者：
McCowan, L. M. E.
中科院分区：
文献类型：
--
作者：
Anderson, N. H.;Sadler, L. C.;McCowan, L. M. E.
请引用本文：安德森·N，萨德勒·L，斯图尔特·A，麦考恩·勒。定制出生体重百分位数的孕妇和病理妊娠特征以及高危小于胎龄儿的识别：一项回顾性队列研究。北京奥组委2012年；第119：848856页。目的使用更新的出生队列重新生成新西兰定制的出生体重百分位数计算器的系数，并比较完全定制(包括产妇特征)和基于超声的胎儿体重和婴儿性别部分定制对高危小于胎龄儿(SGA)的识别。设计前瞻性收集的产妇资料的回溯性队列研究。背景：新西兰奥克兰国家妇女健康中心。20062009期间单胎怀孕人口；n=24176。方法对完全定制化(调整孕期、婴儿性别、母体特征和病理变量)和超声和性别定制化(调整孕期和婴儿性别)进行多元线性回归分析。主要观察指标比较不同模型间SGA相关围产儿死亡的风险。结果中国人(-135g)、汤加人(-101g)、萨摩亚人(-g)等民族系数发生了变化，增加了10个民族。总体而言，完全定制的SGA婴儿围产儿死亡的几率(OR 5.6，95%CI 3.68.7)高于超声和性别定制分类为SGA的婴儿(OR 2.1，95%CI 1.43.3)(P=0.02)。在亚组分析中，完全超声和性别定制被归类为SGA的婴儿(n=888，3.4%)围产儿死亡的风险增加(RR 4.7，95%CI 2.77.9)；然而，仅通过超声和性别定制被确定为SGA的婴儿没有增加风险(n=676，2.6%，RR 1.1，95%CI 0.43.6)。SGA相关围产儿死亡的人群归因风险(PAR)在完全情况下(49.8%)高于超声和性别定制(43.0%)。结论更新新西兰定制的出生体重百分位数计算器后，修正后的系数更好地反映了当代出生人群。将母亲的特征纳入出生体重定制模型，增加了对有围产期死亡风险的SGA婴儿的检测。
Please cite this paper as: Anderson N, Sadler L, Stewart A, McCowan LE. Maternal and pathological pregnancy characteristics in customised birthweight centiles and identification of at-risk small-for-gestational-age infants: a retrospective cohort study. BJOG 2012;119:848856. Objective To regenerate coefficients for the New Zealand customised birthweight centile calculator using an updated birth cohort, and compare the identification of at-risk small-for-gestational-age (SGA) infants between full customisation (including maternal characteristics) and an ultrasound-based fetal weight and infant gender partial customisation. Design Retrospective cohort study of prospectively collected maternity data. Setting National Womens Health Auckland, New Zealand. Population Singleton pregnancies in the period 20062009; n = 24 176. Methods Multiple linear regression analysis was performed for full customisation (adjusted for gestation, infant gender, maternal characteristics and pathological variables) and ultrasound-and-gender customisation (adjusted for gestation and infant gender). Main outcome measures Risks of SGA-related perinatal death were compared between models. Results Changes occurred in some ethnicity coefficients, including Chinese (-135 g), Tongan (-101 g) and Samoan (-89 g), and ten ethnicities were added. Overall, full customisation identified SGA infants with higher odds of perinatal death (OR 5.6, 95% CI 3.68.7) than infants classed as SGA by ultrasound-and-gender customisation (OR 2.1, 95% CI 1.43.3) (P = 0.02). In subgroup analyses, infants classed as SGA by full but not ultrasound-and-gender customisation (n = 888, 3.4%) had an increased risk of perinatal death (RR 4.7, 95% CI 2.77.9); however, those identified as SGA by ultrasound-and-gender customisation alone were not at an increased risk (n = 676, 2.6%, RR 1.1, 95% CI 0.43.6). The population attributable risk (PAR) of SGA-related perinatal death was higher for full (49.8%) than for ultrasound-and-gender (43.0%) customisation. Conclusions Updating the New Zealand customised birthweight centile calculator resulted in revised coefficients that better reflect a contemporary birth cohort. Inclusion of maternal characteristics in a birthweight customisation model increases the detection of SGA infants at risk of perinatal death.