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New references for neonatal weight by gestational age and sex, Holguín, Cuba
Insights
This study created updated birth weight curves for Cuban neonates, identifying more infants as small for gestational age. These new references can improve the identification and care of high-risk newborns.
Area of Science:
- Neonatal health
- Pediatric anthropometry
- Public health
Background:
- Birth weight is a key indicator of neonatal health.
- Existing Cuban birth weight references are outdated and lack gestational age and sex-specific curves.
- WHO guidelines recommend updated, detailed birth weight distributions.
Purpose of the Study:
- To establish birth weight percentile distribution tables and curves for neonates by gestational age and sex in Holguín, Cuba.
- To provide updated reference data for neonatal assessment.
Main Methods:
- A retrospective longitudinal study of 16,018 neonates (30-42 weeks gestation) born between 2008-2012.
- Exclusion of multiple births; data collected on gestational age, sex, and birth weight.
- Construction of sex- and gestational age-specific percentile curves using polynomial regression.
Main Results:
- Average neonatal weight increased from 30 to 42 weeks gestation for both sexes.
- The 10th percentile at 36 weeks was 2140g for girls and 2200g for boys.
- New cutoff points identified 47% more infants as small for gestational age compared to previous standards.
Conclusions:
- Significant differences exist between Cuban birth weight data and international references.
- Higher 10th percentile values in this study indicate more neonates classified as low birth weight.
- Updated references offer improved opportunities for early intervention to reduce neonatal morbidity and mortality.
Introduction:
Birth weight is considered to be the best predictor of an infant's health status in the neonatal phase. In the Americas, several studies have set the foundation for determining references birth weights. In Cuba there is a report on anthropometric patterns in neonates in 1990 from a maternity ward in Havana, but there are no updated neonatal weight distribution curves by gestational age and sex, as suggested by WHO.
Objective:
Create birth weight percentile distribution tables and curves for neonates by gestational age and sex in Holguín Municipality, capital of the eastern Cuban province of the same name.
Methods:
A retrospective longitudinal study was designed in a universe of 16,018 neonates born alive, delivered within a gestational range of 30 to 42 weeks in the maternity unit of the V.I. Lenin University General Hospital in Holguín Municipality between January 2008 and December 2012. Included were neonates born in the study hospital living in Holguín Municipality; neonates from multiple births were excluded. Variables included gestational age, sex, and birth weight. Gestational age- and sex-specific weight percentile distribution tables and curves were constructed based on observed values. A third-degree polynomial was applied via weighted least squares regression to smooth distribution curves. Analysis of variance was conducted to compare four years (2008, 2009, 2010 and 2011) and the coefficient of variation was calculated for each week of gestation.
Results:
The average weight of neonates of both sexes rose from week 30 to week 42. The coefficient of variation between weeks 34 and 42 was 11.6%-19% in girls and 12.1%-21.3% in boys. The 10th percentile value at 36 weeks of gestation was 2140 g for girls and 2200 g for boys. For girls, cutoff points for the 10th percentile (small for gestational age infant) were higher at 34-42 weeks and for boys at 36-42 weeks. Applying our cutoff points to this population identified 47% more low birth weight infants than did previously applied standards.
Conclusions:
Marked differences were found when comparing our tables with tables from other countries. The higher references values for the 10th percentile (compared to previous ones in Cuba) in mean more neonates fall in the low birth weight category, providing greater opportunities to reduce morbidity and mortality in this high-risk group.