Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population

Jong, C.L.D. de; Gardosi, Jason; Dekker, Gustaaf A.; Colenbrander, Gerard J.; Geijn, H.P. van

doi:10.1111/j.1471-0528.1998.tb10154.x

Cited by 144 publications

(96 citation statements)

References 15 publications

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“…These results suggest that the risk of associated neonatal morbidity was slightly higher in the low BF% neonates compared with the standard method (<10th percentile) for detecting risk of hypoglycemia. The neonatal morbidity measure for undernutrition used in our study was based on previous research (23)(24)(25)(26)(27)(28)(29) and clinical input of the pathophysiology of growth restricted neonates. In particular, Kramer et al (23) found that growth restriction was associated with numerous adverse metabolic and neonatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…However, blood glucose testing is not routinely performed on all neonates in the neonatal period, and hypoglycemia is relatively rare in developed countries, therefore this data was not available. In addition, undernourished neonates are more likely to have poor perinatal outcomes such as stillbirth, neonatal death, low Apgar scores (24), operative delivery or cesarean section for reasons of fetal distress (25), hypoglycemia, hypothermia (26), respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, increased length of stay (27), and poor breastfeeding (28,29). Many of these outcomes are also relatively rare in our setting, and data on these outcomes are insufficient for cross-sectional studies.…”

Section: Discussionmentioning

confidence: 99%

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Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

et al. 2013

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Background: Undernutrition in neonates increases the risk of serious morbidities. The objective of this study was to describe neonatal morbidity associated with low body fat percentage (BF%) and measure the number of undernourished neonates defined by BF% and compare this with birth weight percentiles (<10th). Methods: Eligibility included term (≥37 wk) neonates. BF% measurements were undertaken by air displacement plethysmography. Data on neonatal outcomes were extracted from medical records and used to develop a measure of neonatal morbidity. We assessed the association between neonatal morbidity and population-based birth weight percentiles compared with the BF% measurements. results: Five hundred and eighty-one neonates were included. Low BF% was defined by 1 SD below the mean and identified in 73 per 1,000 live births. Neonatal morbidity was found in 3.4% of neonates. Birth weight percentile was associated with neonatal morbidity (odds ratio (OR): 1.03 (95% confidence interval (CI): 1.01, 1.05); P = <0.001). BF% was associated with a higher risk of neonatal morbidity (OR: 1.30 (95% CI: 1.15, 1.47); P = <0.001). conclusion: In this population, measuring BF% is more closely associated with identification of neonates at risk of neonatal morbidity as compared with birth weight percentiles. BF% measurements could assist with identifying neonates who are appropriately grown yet undernourished and exclude small neonates not at risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

et al. 2013

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“…54,55 in addition, customized growth percentiles are better correlated with adverse pregnancy events and reduce the frequency of additional testing because of false-positive screening information. [56][57][58] ultrasound assessment, using uterine artery doppler and placental morphology, is of value to distinguish a subset of pregnancies at high risk of early severe FGR. [59][60][61] In women with risk factors for intrauterine growth restriction, uterine artery doppler screening at 19 to 23 weeks may identify pregnancies at risk of antepartum stillbirth and preterm delivery due to intrauterine growth restriction and placental disease.…”

Section: Screening and Diagnosismentioning

confidence: 99%

Fetal growth restriction: aetiology, screening, diagnosis and management

Augusthy

2015

Int J Reprod Contracept Obstet Gynecol

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Foetal growth restriction (FGR) is a pathological condition that refers to a foetus that fails to reach his/her genetically predetermined growth potential. FGR remains a leading contributor to perinatal mortality and morbidity and metabolic syndrome in later life. The purpose of this review is to provide the summary statements of the aetiology of FGR and to establish a framework for screening, diagnosis, and management of pregnancies affected with foetal growth restriction. For this study, published literature was retrieved through searches of PubMed (Medline), Highwire, Google Scholar, Scopus, Cochrane Database of Systematic Reviews. Conference/Seminar proceedings, textbooks, previously published systematic reviews, controlled clinical trials, high quality prospective and retrospective observational studies, research articles and unpublished studies were also used for this study. The identification of FGR begins with assessment of maternal, foetal, placental and environmental risk factors and the diagnosis is made by Ultrasound biometry examination. Functional assessment of placental and foetal circulation by Doppler velocimetry and blood flow volume, together with computerized assessment of foetal heart rate variability, are key examinations in early and late FGR to assess severity of the disease and monitor foetal wellbeing. Appropriate timing of delivery in early FGR might change the outcome, and appropriate monitoring in late and term FGR might avoid unnecessary interventions.

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“…(9). Such customized fetal growth estimation allows to reduce false-positive diagnosis of FGR in low-risk population (20) and significantly improves identification of infants who have failed to reach their genetic potential and who are at increased risk for adverse perinatal events in geographically different high-risk populations (21,22). Therefore, when assessing fetal growth in this study, EFWs during four ultrasound scans from mid-gestation to near-term and infants' birth weights were converted into individually adjusted percentiles using a customized growth standard method (17).…”

Section: Determinants Of Birth Weight and Body Compositionmentioning

confidence: 99%

Impact of fetal growth restriction on body composition and hormonal status at birth in infants of small and appropriate weight for gestational age

Verkauskienė¹,

Beltrand²,

Claris

et al. 2007

European Journal of Endocrinology

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Background: Fetal growth restriction (FGR) has been related to several health risks, which have been generally identified in small-for-gestational age (SGA) individuals. Objective: To evaluate the impact of FGR on body composition and hormonal status in infants born either small-or appropriate-for-gestational age (AGA). Methods: Fetal growth was assessed by ultrasound every 4 weeks from mid-gestation to birth in 248 high-risk pregnancies for SGA. Fetal growth velocity was calculated as change in the estimated fetal weight percentiles and FGR defined as its reduction by more than 20 percentiles from 22 gestational weeks to birth. Impact of FGR on body composition, cord insulin, IGF-I, IGF binding protein-3 (IGFBP-3), and cortisol concentrations was assessed in SGA and AGA newborns. Results: Growth-retarded AGA infants showed significantly reduced birth weight, ponderal index, percentage of fat mass, and bone mineral density when compared with AGA newborns with stable intrauterine growth. Cord IGF-I and IGFBP-3 concentrations were significantly decreased in growthretarded infants in both SGA and AGA groups. Cord insulin concentration was significantly lower and cord cortisol significantly higher in AGA infants with FGR versus AGA newborns with stable intrauterine growth.After adjustment for gestational age and gender, birth weight was directly related to fetal growth velocity and cord IGF-I concentration. The variation in infant's adiposity was best explained by fetal growth velocity and cord insulin concentration. Conclusions: FGR affects body composition and hormonal parameters in newborns with birth weight within the normal range, suggesting these individuals could be at similar metabolic risks as SGA.

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Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population

Cited by 144 publications

References 15 publications

Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

Is body fat percentage a better measure of undernutrition in newborns than birth weight percentiles?

Fetal growth restriction: aetiology, screening, diagnosis and management

Impact of fetal growth restriction on body composition and hormonal status at birth in infants of small and appropriate weight for gestational age

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