非常低出生体重的婴儿被分类为与妊娠年龄相比较小的婴儿:国际与国家标准
Marta Tejón-Fernández1, Ana Isabel Armenteros-López2, Nazareth Fernández-Rosales2
1Department of Biomedical Investigation, Foundation for Biosanitary Research in Eastern Andalusia-FIBAO, Almeria, Spain.
PloS one
|May 8, 2025
概括
国际成长-21和卡拉斯科萨2008标准显示,对分类小到孕期婴儿的标准具有很高的一致性. 这两个标准都导致了相似的发病率和死亡率,但为了更广泛的适用性,建议使用INTERGROWTH-21.
科学领域:
- 新生儿科学 新生儿科学
- 儿科生长标准 儿科生长标准
- 公共卫生 公共卫生
背景情况:
- 准确地对孕期小婴儿 (SGA) 进行分类,对于预测新生儿结果至关重要.
- 国家 (Carrascosa 2008) 和国际 (INTERGROWTH-21) 增长标准被使用,但它们在SGA分类中的一致性和对发病率/死亡率的影响尚不清楚.
研究的目的:
- 评估卡拉斯科萨2008和INTERGROWTH-21标准之间的一致性,用于分类体重小于1500克的SGA新生儿.
- 为了比较每个标准所确定的SGA新生儿的发病率和死亡率.
主要方法:
- 对出生时体重非常低 (<1500克) 的婴儿进行了回顾性队列研究,这些婴儿出生在妊娠26-36周之间.
- 使用科恩卡帕进行一致性分析,比较INTERGROWTH-21和卡拉斯科萨2008标准之间的SGA分类 (z分数≤-1.28).
- 通过两种标准确定的SGA新生儿之间的妊娠年龄,体重,医疗需求,发病率和死亡率的比较.
主要成果:
- 在SGA分类的INTERGROWTH-21和卡拉斯科萨2008标准之间观察到很高的一致性 (科恩的卡帕=0.80,p<0.001).
- 在INTERGROWTH-21标准中,与Carrascosa 2008 (40.8%,p = 0.03) 相比,SGA的发病率较低 (31.6%).
- 根据任何标准分类的SGA新生儿之间没有发现死亡率或发病率的显著差异.
结论:
- 卡拉斯科萨2008年和INTERGROWTH-21标准表明,SGA婴儿的发病率和死亡率的结果相似.
- 建议采用INTERGROWTH-21标准,因为它包括多胎妊娠,多种种族,以及国际可比性.
- 这些发现支持在临床实践和研究中使用INTERGROWTH-21进行一致的SGA分类.
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