对于胎儿体重和出生体重百分点的全球参考
Rafael T Mikolajczyk1, Jun Zhang, Ana Pilar Betran
1Department of Clinical Epidemiology, Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany.
Lancet (London, England)
|May 31, 2011
概括
适应当地人口的新通用胎儿体重参考值,改善了对周围生育不良结果的预测. 这种方法比个性化参考更简单,比非个性化参考更准确,用于识别怀孕年龄较小的婴儿.
科学领域:
- 围产期健康研究
- 生物统计学 生物统计学
- 全球公共卫生全球公共卫生
背景情况:
- 全球范围内对妊娠年龄 (SGA) 进行小的定义是具有挑战性的,因为现有的出生体重参考标准存在局限性,特别是在早产和多样化的人口中.
- 超声波衍生引用可能缺乏普遍适用性,而个性化引用可能在资源有限的环境中过于复杂.
- 现有的方法很难在全球不同的人口中提供准确的SGA评估.
研究的目的:
- 开发一种通用的胎儿体重和出生体重参考值,易于适应全球当地人口.
- 克服现有的非定制和个性化的SGA参考书的缺陷.
- 创建一个实用和准确的工具来识别SGA婴儿在不同的全球环境.
主要方法:
- 通过使用加尔多西的比例概念来调整哈德洛克的参考来创建一个通用的胎儿体重参考,允许根据40周出生体重的平均值进行本地适应.
- 来自非洲,拉丁美洲和亚洲24个国家的237,025例分娩的数据 (世卫组织全球孕产妇和产周健康调查) 用于验证.
- 多级逻辑回归分析了SGA婴儿与非SGA婴儿相比,SGA婴儿不良周产期结果的几率比率 (OR),使用三个参考类型:非定制,国家特定和个性化.
主要成果:
- 与非定制的哈德洛克参考 (1.59) 相比,国家特定参考显示SGA婴儿 (2.87) 的不良结果的几率比率 (OR) 显著更高.
- 完全个性化的参考还显示了不良结果的高OR (2.84),与特定国家参考结果相比较.
- 开发的通用参考,当适应国家特定数据时,显示出与不良围产期结果的强烈关联.
结论:
- 建议的胎儿和出生体重百分比的通用参考很容易适应当地人口,增强其全球效用.
- 这种可适应的参考资料表明,与非定制参考资料相比,在预测不良围产期结果方面具有更好的能力.
- 该方法为完全个性化的参考提供了一个更简单的替代方案,而不影响预测准确性,使其适用于各种医疗保健环境.
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