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Clinical study of heavy-for-dates neonates
1Maternal and Perinatal Center, Tokyo Women's Medical College, Japan.
Insights
Heavy-for-dates neonates show increased morbidity, primarily due to birth trauma. An absolute birth weight of over 3750 g is a more effective screening criterion than the standard definition for identifying at-risk neonates.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Public Health
Background:
- Heavy-for-dates (HFD) neonates are defined by specific fetal growth curves, but their associated risks require ongoing evaluation.
- Understanding the incidence and morbidity of HFD neonates is crucial for identifying optimal screening criteria.
Purpose of the Study:
- To examine the incidence and morbidity rates of HFD neonates.
- To evaluate the effectiveness of current HFD criteria versus absolute birth weight for risk screening.
Main Methods:
- Analysis of 15,377 term neonates born between 1984-1990 (excluding still-births and neonates from non-Japanese mothers).
- Comparison of morbidity rates based on HFD definition (mean +1.5 s.d.) and absolute birth weight thresholds (e.g., >3750 g).
Main Results:
- Overall HFD incidence was 5.13%.
- Morbidity rate was 10.0%, increasing with gestational age and associated with birth trauma.
- Neonates with birth weight >3750 g exhibited significantly higher morbidity rates compared to HFD criteria.
- Hospitalizations were mainly for birth trauma and respiratory disorders; hypoglycemia and polycythemia were infrequent.
Conclusions:
- Absolute birth weight of >3750 g is a more appropriate screening criterion for identifying high-risk heavy neonates than the standard HFD definition.
- Delivery complications due to heavy birth weight are the primary driver of hospitalization for these infants.
Abstract:
Incidence and morbidity rates of heavy-for-dates (HFD) term neonates were examined to elucidate whether HFD neonates are at high risk. At the same time the criteria for HFD, defined by the fetal growth curve published in 1983 by the Ministry of Health and Welfare, were evaluated. A sample of 15,377 term neonates who were born between 1984 and 1990 were obtained. Still-births and neonates from non-Japanese mothers were excluded. The overall incidence of HFD neonates was 5.13%. The morbidity rate excluding idiopathic hyperbilirubinemia was 10.0%, which increased with gestational age and was accompanied by an increment of birth trauma. The main diagnosis of hospitalization of HFD neonates was birth trauma followed by respiratory disorders. The incidences of hypoglycemia and polycythemia, regarded as major problems of HFD neonates, were low. The main causes of hospitalization of HFD neonates are associated with difficulty at delivery due to their heavy weight. There were no significant differences in the morbidity rate of neonates defined by the deviation of birth-weight from the mean +1.3 s.d. to +2.5 s.d. On the other hand, neonates of birth weight over 3750 g had significantly high morbidity rates. Criteria defined by the absolute birth-weight of over 3750 g are more appropriate to screen risk neonates with heavy weight rather than the criteria for HFD as being above mean birth-weight +1.5 s.d.