The case against customised birthweight standards
The case against customised birthweight standards
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DOI：
10.1111/j.1365-3016.2010.01155.x
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发表时间：
2011-01-01
影响因子：
2.8
通讯作者：
Kramer, Michael S.
中科院分区：
文献类型：
--
作者：
Hutcheon, Jennifer A.;Zhang, Xun;Kramer, Michael S.
哈钦JA，张X，普拉特RW，Cnattingius S，克雷默MS。反对定制出生体重标准的案例。2010年儿科和围产期流行病学。与传统的胎龄出生体重图表相比，定制出生体重标准被广泛认可，可改善对围产期不良结局的预测。然而，它们的明显益处更可能来自于它们在早产年龄时纳入基于子宫内（EFW）的参考值，而不是它们对母体特征的调整。虽然母亲的特征能够解释出生体重的人口水平的差异，他们不是足够强的预测因子，为个人水平的预测出生体重。由于母亲特征在影响出生体重的所有因素中只占很小的百分比，婴儿出生体重的最佳估计数仍然接近人口平均数，这解释了调整母亲特征无效的原因。鉴于定制的体重计也无法区分母体特征对出生体重的病理和生理影响，因此为母体特征定制出生体重计几乎没有理由。
P>Hutcheon JA, Zhang X, Platt RW, Cnattingius S, Kramer MS. The case against customised birthweight standards. Paediatric and Perinatal Epidemiology 2010.Customised birthweight standards are widely recognised to improve the prediction of adverse perinatal outcomes compared with conventional birthweight-for-gestational-age charts. However, their apparent benefits are more likely to have been derived from their incorporation of intrauterine-based (EFW) reference values at preterm ages than their adjustment for maternal characteristics. Although maternal characteristics are able to explain population-level differences in birthweight, they are not strong enough predictors for individual-level prediction of birthweight. With maternal characteristics accounting for only a small per cent of the total factors influencing birthweight, the best estimate of an infant's birthweight remains close to the population average, explaining the ineffectiveness of adjusting for maternal characteristics. Given that customised percentiles are also unable to distinguish between pathological and physiological influences of maternal characteristics on birthweight, customising birthweight percentiles for maternal characteristics has little justification.