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[Identification of a high-risk new neonatal population with Peruvian fetal growth curve]
Manuel Ticona Rendón1, Diana Huanco Apaza
1Universidad Nacional Jorge Basadre Grohmann, Tacna, Perú. manuelticonar@yahoo.es
Insights
Peruvian growth curves identified more small for gestational age newborns than Lubchenco curves, revealing a high-risk group. These newborns face significantly increased risks of mortality and various morbidities.
Area of Science:
- Perinatology
- Neonatal research
- Public health
Context:
- Accurate identification of newborns at risk is crucial in modern perinatology.
- Existing growth charts may not accurately reflect local populations.
- Peruvian growth curves offer a more precise assessment for the region.
Purpose:
- To quantify small for gestational age (SGA) newborns using Peruvian intrauterine growth curves.
- To analyze the morbidity and mortality risks associated with a newly identified group of SGA newborns.
- To compare the efficacy of Peruvian versus Lubchenco growth curves.
Summary:
- A prospective study of 95,751 neonates in Peru revealed that Peruvian growth curves identified 10.1% SGA newborns, compared to 4.1% with Lubchenco curves.
- This resulted in an additional 5,765 SGA newborns (6% of the total population).
- The newly identified SGA newborns exhibited significantly higher risks for neonatal mortality (OR: 15.6), metabolic disorders, congenital malformations, infections, respiratory distress, and perinatal asphyxia.
Impact:
- Peruvian growth curves are superior to Lubchenco curves for identifying SGA newborns in Peru.
- Highlights a vulnerable population of 'new' SGA newborns requiring targeted interventions.
- Informs clinical practice and public health strategies for improving neonatal outcomes in Peru.
Background:
Early detection of risk factors in newborns is an essential aim in modern perinatology.
Objective:
To know quantity of small for gestational age newborns by means of Peruvian curves of intrauterine growth, and to study them morbidity-mortality risks associated to a new neonates group. MATEIRIAL AND METHODS: Prospective, analytic, and case-control study. There were 95,751 neonates born in 2005, from 29 hospitals of Ministerio de Salud del Perú; they were classified by weight using Peruvian and Lubchenco growth curves. Percent distribution was compared (p < 0.05). Risks of morbidity-mortality in additional small for gestational age newborns (called new) were compared with adecuate for gestational age (37 to 42 weeks; IC 95%). Data Perinatal System was used.
Results:
Large for gestational age newborns meaningfully decreases from 14.3 to 11.4%, as adequate for gestational age newborns from 81.7 to 78.5%, and small for gestational age newborns raises from 4.1 to 10.1%. There were 9,664 small for gestational age newborns using Peruvian curve, and 3,899 using Lubchenco one. The difference of 5,765 newborns (6% of total population) corresponds to new small for gestational age newborns that had this risks: neonatal mortality (OR: 15.6); metabolic disorders (OR: 2.2); congenital malformations (OR: 2.1); infections (OR: 2); respiratory distress syndrome (OR: 1.8); perinatal asphyxia (OR: 1.7), and neonatal morbidity (OR: 1.5).
Conclusions:
Lubchenco's curve overestimate large for gestational age newborns and underestimate small for gestational age newborns; due to this is a poor pattern to apply in Peruvian newborns. New small for gestational age newborns are a group with high morbidity-mortality risk.
