Association between risk of infant death and birth-weight z scores according to gestational age: A nationwide study using the Finnish Medical Birth Register.

Autor: Hocquette A; Université Paris Cité, CRESS, INSERM, INRA, Paris, France., Pulakka A; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.; Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland., Metsälä J; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland., Heikkilä K; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.; Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland., Zeitlin J; Université Paris Cité, CRESS, INSERM, INRA, Paris, France., Kajantie E; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.; Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.; Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Dec; Vol. 167 (3), pp. 1138-1145. Date of Electronic Publication: 2024 Jul 12.
DOI: 10.1002/ijgo.15772
Abstrakt: Objective: To investigate the association between infant mortality and birth weight using estimated fetal weight (EFW) versus birth-weight charts, by gestational age (GA).
Methods: This nationwide population-based study used data from the Finnish Medical Birth Register from 2006 to 2016 on non-malformed singleton live births at 24-41 +6 weeks of gestation (N = 563 630). The outcome was death in the first year of life. Mortality risks by birth-weight z score, defined as a continuous variable using Maršál's EFW and Sankilampi's birth-weight charts, were assessed using generalized additive models by GA (24-27 +6 , 28-31 +6 , 32-36 +6 , 37-38 +6 , 39-41 +6  weeks). We calculated z score thresholds associated with a two- and three-fold increased risk of infant death compared with newborns with a birth weight between 0 and 0.675 standard deviations.
Results: The z score thresholds (with corresponding centiles in parentheses) associated with a two-fold increase in infant mortality were: -3.43 (<0.1) at 24-27 +6 weeks, -3.46 (<0.1) at 28-31 +6 weeks, -1.29 (9.9) at 32-36 +6 weeks, -1.18 (11.9) at 37-38 +6 weeks, and - 1.34 (9.0) at 39-41 +6 weeks according to the EFW chart. These values were - 2.43 (0.8), -2.62 (0.4), -1.34 (9.0), -1.37 (8.5), and - 1.43 (7.6) according to the birth-weight chart.
Conclusion: The association between birth weight and infant mortality varies by GA whichever chart is used, suggesting that different thresholds for the screening of growth anomalies could be used across GA to identify high-risk newborns.
(© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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