根据母亲所在世界区域定制的出生体重曲线。

Birth weight curves tailored to maternal world region.

作者信息

Ray Joel G, Sgro Michael, Mamdani Muhammad M, Glazier Richard H, Bocking Alan, Hilliard Robert, Urquia Marcelo L

机构信息

Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto ON; Department of Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto ON; Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto ON.

Department of Paediatrics, St. Michael's Hospital, University of Toronto, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto O.

出版信息

J Obstet Gynaecol Can. 2012 Feb;34(2):159-171. doi: 10.1016/S1701-2163(16)35159-3.

DOI:10.1016/S1701-2163(16)35159-3

PMID:22340065

Abstract

BACKGROUND

Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves.

METHODS

We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin.

RESULTS

Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used.

CONCLUSIONS

Birth weight curves need to be modified for newborns of immigrant mothers originating from non-European/Western nations.

摘要

背景

某些移民母亲所生的新生儿出生时比本国母亲所生的新生儿体型小。目前缺乏针对这些新生儿的基于当代人群的百分位数曲线，也缺乏使用传统而非量身定制的出生体重曲线将他们误分类为过小或过大的风险估计。

方法

我们对2002年至2007年安大略省766688例单胎活产进行了一项基于人群的研究。按母亲出生的世界区域分类，为男性和女性生成了平滑的出生体重百分位数曲线：加拿大（63.5%）、欧洲/西方国家（7.6%）、非洲/加勒比地区（4.9%）、中东/北非（3.4%）、拉丁美洲（3.4%）、东亚/太平洋地区（8.1%）和南亚（9.2%）。我们确定了在加拿大出生母亲的曲线与特定于母亲出生世界区域的曲线之间，将婴儿误分类为小于胎龄儿（体重≤第10百分位数）或大于胎龄儿（体重≥第90百分位数）的可能性。

结果

与加拿大出生母亲的婴儿相比，除欧洲/西方国家外，每个世界区域母亲所生足月儿在特定孕周的第10、50和90百分位数处的出生体重明显较低。例如，对于孕40周出生的南亚婴儿，第10百分位数处男性的绝对差异为198克（95%可信区间183至212），女性为170克（95%可信区间161至179）。在控制母亲年龄和产次后，南亚男性被误分类为小于胎龄儿的比值比为2.60（95%可信区间2.53至2.68），相当于每1000例新生儿中约有116例；南亚女性的比值比为2.41（95%可信区间2.34至2.48），相当于每1000例新生儿中约有106例。如果使用传统而非种族特异性的出生体重曲线，每1000例南亚新生儿中，约有61例男性和57例女性会被漏诊为大于胎龄儿。