Gibbons Kristen, Chang Allan, Flenady Vicki, Mahomed Kassam, Gardener Glenn, Gray Peter H, Beckmann Michael, Rossouw Dominique
Clinical Research Support Unit, Mater Medical Research Institute, South Brisbane, QLD, Australia.
J Paediatr Child Health. 2013 May;49(5):380-7. doi: 10.1111/jpc.12189. Epub 2013 Apr 22.
The study aims to describe the cohort of women and babies who are classified as small-for-gestational age (SGA) at term by both an Australian customised birthweight model (CBM) and a commonly used population-based standard, and to investigate and compare the utility of these models in identifying babies at risk of experiencing adverse outcomes
Routinely collected data on 54 890 singleton-term births at the Mater Mothers' Hospitals, Brisbane, with birthweight less than 4000 g between January 1997 and December 2008, was extracted. Each birth was classified as SGA (<10th centile) or not SGA by either and/or both methods: population-based standards (SGApop ) and CBM (SGAcust ). Babies classified as SGApop , SGAcust or SGAboth were compared with those not classified as SGA by both methods using relative risk and 95% confidence interval, and those only classified as SGAcust were compared with those only classified as SGApop . Maternal demographics, maternal risk factors for fetal growth restriction, pregnancy and labour complications and adverse neonatal outcomes are reported.
A total of 4768 (8.7%) births were classified as SGApop , while 6479 (11.8%) were SGAcust of whom 4138 (63.9%) were also classified as SGApop . Maternal risk factors such as smoking and hypertension were statistically higher for the SGAcust group when compared with SGApop . For the majority of adverse neonatal outcomes, a trend was noted to increased identification using the CBM.
The CBM provides a modest improvement when compared to a population-based standard to identity term infants at birth who are at risk of adverse neonatal outcomes.
本研究旨在描述根据澳大利亚定制出生体重模型（CBM）和常用的基于人群的标准在足月时被归类为小于胎龄儿（SGA）的女性和婴儿队列，并调查和比较这些模型在识别有不良结局风险婴儿方面的效用。
提取了1997年1月至2008年12月在布里斯班马特母亲医院常规收集的54890例单胎足月分娩数据，这些婴儿出生体重小于4000克。每次分娩通过以下一种和/或两种方法分类为SGA（<第10百分位数）或非SGA：基于人群的标准（SGApop）和CBM（SGAcust）。使用相对风险和95%置信区间，将分类为SGApop、SGAcust或SGAboth的婴儿与未通过两种方法分类为SGA的婴儿进行比较，并将仅分类为SGAcust的婴儿与仅分类为SGApop的婴儿进行比较。报告了产妇人口统计学、胎儿生长受限的产妇风险因素、妊娠和分娩并发症以及不良新生儿结局。
共有4768例（8.7%）分娩被分类为SGApop，而6479例（11.8%）为SGAcust，其中4138例（63.9%）也被分类为SGApop。与SGApop相比，SGAcust组的吸烟和高血压等产妇风险因素在统计学上更高。对于大多数不良新生儿结局，使用CBM发现有增加识别的趋势。
与基于人群的标准相比，CBM在识别有不良新生儿结局风险的足月出生婴儿方面有适度改善。
