New Reference Curves for Head Circumference at Birth, by Gestational Age
New Reference Curves for Head Circumference at Birth, by Gestational Age
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DOI：
10.1542/peds.2011-3846
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发表时间：
2013-04-01
期刊：
影响因子：
8
通讯作者：
Nuyt, Anne Monique
中科院分区：
文献类型：
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作者：
Barbier, Alexandre;Boivin, Ariane;Nuyt, Anne Monique
背景：出生时头围(HC)的测量反映了胎儿大脑的发育。方法：为了创建出生体重和HC曲线，我们结合了来自加拿大新生儿网络(CNN)数据库(加拿大各地NICU的入院人数)和McGill的产科新生儿数据库(MOND；加拿大蒙特利尔一家三级医院出生的所有新生儿)的体重和HC数据。我们纳入了23-34周GAS的CNN数据(2003-2007)和35-41周GAS的MOND数据(1995-2006)。排除了非独生子女、先天畸形和大于平均值+/-4SD的测量值。对每个遗传算法的出生体重和Hc的分布进行统计平滑(惩罚样条法回归)。结果：我们收集了39896例出生体重曲线(出生30周时出生的3121例)来生成曲线。目前的体重曲线与加拿大的性别参考图相似。男孩的体重和HC测量值高于女孩。当根据最新的国际参考资料进行分类时，CNN-MOND婴儿在胎龄=32周时患有HCS<；10%的比例被严重低估。当根据历史参考曲线分类时，相当数量的具有HCS 90%的GAS的CNN-MOND婴儿被错误分类。结论：我们最近为出生23至41周的单身婴儿建立了特定性别的HC参考曲线，其中包括大量极早产儿，反映了当前加拿大的地理时空人口。儿科2013；131：e1158-e1167
BACKGROUND: The measurement of head circumference (HC) at birth reflects intrauterine brain development. HC charts currently used in Canada are either dated, mixed-gender, nonrepresentative of lower gestational ages (GAs), or reflective of other populations.METHODS: To create both birth weight and HC curves, we combined weight and HC data from the Canadian Neonatal Network (CNN) database (admissions in NICUs across Canada) with McGill's Obstetrical Neonatal Database (MOND; all births at a tertiary hospital in Montreal, Canada). We included CNN data for GAs of 23 to 34 weeks (2003-2007) and MOND data for GAs of 35 to 41 weeks (1995-2006). Nonsingletons, congenital anomalies, and measurements greater than +/- 4 SD from the mean were excluded. Distributions of birth weight and HC at each GA were statistically (penalized spline regression) smoothed. Birth weight curves were compared with recent Canadian reference curves and HC curves with historical and/or frequently used curves.RESULTS: We included 39 896 births (3121 births at,30 weeks' GA) to generate the curves. Current weight curves were similar to Canadian reference charts for both genders. Weight and HC measurements in boys were higher than in girls. When classified according to recent international references, the proportion of CNN-MOND infants at >= 32 weeks' GA with HCs < 10th percentile was significantly underestimated. When classified according to historical reference curves, a significant number of CNN-MOND infants of all GAs with HCs 90th percentiles were misclassified.CONCLUSIONS: We developed recent gender-specific reference curves for HC at birth for singletons at 23 to 41 completed weeks' GA, which included a large number of very premature infants, reflecting the current geotemporal Canadian population. Pediatrics 2013; 131: e1158-e1167