Birth weight in relation to morbidity and mortality among newborn infants
Birth weight in relation to morbidity and mortality among newborn infants
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DOI：
10.1056/nejm199904223401603
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发表时间：
1999-04-22
影响因子：
158.5
通讯作者：
Leveno, KJ
中科院分区：
文献类型：
--
作者：
McIntire, DD;Bloom, SL;Leveno, KJ
背景在任何胎龄，低出生体重儿有相对较高的发病率和死亡率。然而，目前尚不清楚是否有一个阈值重量低于发病率和死亡率显着higher.Methods我们分析了新生儿的死亡结局，五分钟阿普加评分，脐动脉血pH值，并因早产的发病率为所有单胎婴儿在帕克兰医院，达拉斯，1988年1月11日至8月31日，1996.根据出生时的妊娠周创建出生体重分布。体重在26至75磅之间的婴儿作为参考组。对早产儿（妊娠24 ~ 36周出生的婴儿）的数据和足月分娩的婴儿（妊娠37周或以上）的数据分别进行分析。结果共有122,754名妇女和青少年在妊娠24 ~ 43周之间分娩了无畸形的单胎活婴。在分析的12,317名早产儿中，没有发病率和死亡率增加的特定出生体重百分位数。然而，在82,361名足月出生且出生体重等于或低于第75百分位数的婴儿中，新生儿死亡率从参考组（体重第26至第75百分位数）的0.03%增加到出生体重等于或低于第3百分位数的0.3%（P
Background At any given gestational age, infants with low birth weight have relatively high morbidity and mortality. It is not known, however, whether there is a threshold weight below which morbidity and mortality are significantly greater, or whether that threshold varies with gestational age.Methods We analyzed the neonatal outcomes of death, five-minute Apgar score, umbilical-artery blood pH, and morbidity due to prematurity for all singleton infants delivered at Parkland Hospital, Dallas, between January 11 1988, and August 31, 1996. A distribution of birth weights according to week of gestation at birth was created. Infants in the 26th through 75th percentiles for weight served as the reference group. Data on preterm infants (those born at 24 to 36 weeks of gestation) were analyzed separately from data on infants delivered at term (37 or more weeks of gestation).Results A total of 122,754 women and adolescents delivered singleton live infants without malformations between 24 and 43 weeks of gestation. Among the 12,317 preterm infants who were analyzed, there was no specific birth-weight percentile at which morbidity and mortality increased. Among 82,361 infants who were born at term and whose birth weights were at or below the 75th percentile, however, the rate of neonatal death increased from 0.03 percent in the reference group (26th through 75th percentile for weight) to 0.3 percent for those with birth weights at or below the 3rd percentile (P