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出生体重与孕期年龄的百分比可以预测严重的新生儿发病率和新生儿死亡率吗?

Sid John^1,2, K S Joseph^1,2,3, John Fahey⁴

¹Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.

Paediatric and perinatal epidemiology

|September 9, 2025

概括

在特定高风险群体的多变量模型中,出生体重百分比提高了严重新生儿发病率和死亡率 (SNMM) 的预测. 需要进一步评估以确定临床意义.

科学领域:

新生儿健康新生儿健康
预测建模预测建模
围产期流行病学围产期流行病学

背景情况:

在单变量分析中,胎儿和出生体重对妊娠年龄的百分点是严重新生儿发病率和死亡率 (SNMM) 的不足预测指标.
现有的模型往往无法准确识别高风险的新生儿.

研究的目的:

评估多变量SNMM模型的预测性能.
评估将出生体重百分点纳入这些模型的影响.

主要方法:

利用来自美国国家卫生统计中心的美国活产数据 (2019-2021年).
根据阿普加尔评分,,辅助呼吸或新生儿死亡来定义SNMM.
开发了使用母体/怀孕特征的日志线性回归模型,有或没有出生体重百分点,用于各种妊娠年龄和母体条件.
使用曲线下的面积 (AUC) 评估模型性能.

主要成果:

所有活产儿 (24-42周) 的模型显示AUC为0.83,与出生体重百分比的微小改善.
对于39周怀孕的分娩,AUC为0.66 (没有百分位数) 和0.69 (有百分位数).
对于39周先前患有糖尿病的母亲的分娩,AUC从0.69增加到0.77与出生体重百分比.

结论:

出生体重百分比提高了多变量SNMM模型在特定亚种群的预测准确性,例如那些有先前存在的糖尿病.
临床效用取决于评估决策值,以确定这些预测性改进的重要性.

关键词:

在曲线下面的面积.出生的体重出生时的体重.出生体重与妊娠年龄的关系新生儿死亡率新生儿死亡率预测预测预测预测严重的新生儿发病率

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