Boulet Sheree L, Alexander Greg R, Salihu Hamisu M, Kirby Russell S, Carlo Waldemar A
Department of Maternal and Child Health, School of Public Health University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
Am J Obstet Gynecol. 2006 Dec;195(6):1571-7. doi: 10.1016/j.ajog.2006.03.069. Epub 2006 Jun 12.
We developed a fetal growth risk curve that delineates the birth weight values for gestational age that reflect a 2-, 2.5-, and 3-fold neonatal death risk relative to infants with normal fetal growth.
We analyzed 18,085,052 single gestation infants (25-42 weeks) who were born to US resident mothers from 1996 to 2000. Multivariate models were used to predict the relationship between neonatal death and birth weight percentile. Fetal risk curves were derived on the basis of birth weight percentile-specific neonatal mortality rates that were relative to an average rate of neonatal death for a comparison group that was representative of typical growth (ie, infants between 45th-55th birth weight percentiles for gestational age).
The 10th percentile of birth weight for gestational age is associated with an increased but variable risk of neonatal death relative to the comparison group across the spectrum of gestational ages. At 26 weeks of gestation, infants at the 10th percentile experienced a 3-fold risk of dying within the first 28 days of life (relative to the comparison group); whereas at 40 weeks, the risk was 1.13.
Fetal growth risk curves facilitate the identification of populations of infants whose risk of death are deemed excessive compared with that of infants at the norm of fetal growth and may be useful for counseling pregnant women.
我们绘制了一条胎儿生长风险曲线，该曲线描绘了不同孕周对应的出生体重值，这些值反映了相对于胎儿生长正常的婴儿，新生儿死亡风险分别为2倍、2.5倍和3倍的情况。
我们分析了1996年至2000年在美国居住的母亲所生的18,085,052名单胎妊娠婴儿（孕周为25 - 42周）。使用多变量模型预测新生儿死亡与出生体重百分位数之间的关系。胎儿风险曲线是根据出生体重百分位数特定的新生儿死亡率得出的，这些死亡率相对于一个代表典型生长情况的对照组（即孕周对应的出生体重百分位数在第45 - 55百分位数之间的婴儿）的新生儿平均死亡率。
相对于对照组，不同孕周的出生体重第10百分位数与新生儿死亡风险增加但变化不定相关。在孕26周时，处于第10百分位数的婴儿在出生后28天内死亡的风险为对照组的3倍；而在孕40周时，风险为1.13倍。
胎儿生长风险曲线有助于识别那些与胎儿生长正常的婴儿相比死亡风险被认为过高的婴儿群体，可能有助于为孕妇提供咨询。
