古巴奥尔金市按胎龄和性别划分的新生儿体重新参考标准。

Martínez Pedro A, Díaz Pedro, Romero Antonia, Barroso Bárbara

MEDICC Rev. 2015 Jan;17(1):18-22. doi: 10.37757/MR2015.V17.N1.5.

INTRODUCTION

Birth weight is considered to be the best predictor of an infant's health status in the neonatal phase. In the Americas, several studies have set the foundation for determining references birth weights. In Cuba there is a report on anthropometric patterns in neonates in 1990 from a maternity ward in Havana, but there are no updated neonatal weight distribution curves by gestational age and sex, as suggested by WHO.

OBJECTIVE

Create birth weight percentile distribution tables and curves for neonates by gestational age and sex in Holguín Municipality, capital of the eastern Cuban province of the same name.

METHODS

A retrospective longitudinal study was designed in a universe of 16,018 neonates born alive, delivered within a gestational range of 30 to 42 weeks in the maternity unit of the V.I. Lenin University General Hospital in Holguín Municipality between January 2008 and December 2012. Included were neonates born in the study hospital living in Holguín Municipality; neonates from multiple births were excluded. Variables included gestational age, sex, and birth weight. Gestational age- and sex-specific weight percentile distribution tables and curves were constructed based on observed values. A third-degree polynomial was applied via weighted least squares regression to smooth distribution curves. Analysis of variance was conducted to compare four years (2008, 2009, 2010 and 2011) and the coefficient of variation was calculated for each week of gestation.

RESULTS

The average weight of neonates of both sexes rose from week 30 to week 42. The coefficient of variation between weeks 34 and 42 was 11.6%-19% in girls and 12.1%-21.3% in boys. The 10th percentile value at 36 weeks of gestation was 2140 g for girls and 2200 g for boys. For girls, cutoff points for the 10th percentile (small for gestational age infant) were higher at 34-42 weeks and for boys at 36-42 weeks. Applying our cutoff points to this population identified 47% more low birth weight infants than did previously applied standards.

CONCLUSIONS

Marked differences were found when comparing our tables with tables from other countries. The higher references values for the 10th percentile (compared to previous ones in Cuba) in mean more neonates fall in the low birth weight category, providing greater opportunities to reduce morbidity and mortality in this high-risk group.

引言

出生体重被认为是新生儿期婴儿健康状况的最佳预测指标。在美洲，多项研究为确定出生体重参考值奠定了基础。古巴有一份1990年来自哈瓦那一家产科病房的新生儿人体测量模式报告，但尚无世界卫生组织建议的按胎龄和性别划分的最新新生儿体重分布曲线。

目的

创建古巴同名东部省份首府奥尔金市按胎龄和性别划分的新生儿出生体重百分位数分布表和曲线。

方法

设计了一项回顾性纵向研究，研究对象为16018例活产新生儿，于2008年1月至2012年12月在奥尔金市列宁大学综合医院产科出生，孕周在30至42周之间。纳入对象为在研究医院出生且居住在奥尔金市的新生儿；排除多胞胎新生儿。变量包括胎龄、性别和出生体重。根据观察值构建了按胎龄和性别划分的体重百分位数分布表和曲线。通过加权最小二乘法回归应用三次多项式来平滑分布曲线。进行方差分析以比较四年（2008年、2009年、2010年和2011年）的情况，并计算每个孕周的变异系数。

结果

两性新生儿的平均体重从第30周上升到第42周。女孩在第34至42周的变异系数为11.6%-19%，男孩为12.1%-21.3%。孕36周时，女孩的第10百分位数为2140克，男孩为2200克。对于女孩，第34至42周第10百分位数（小于胎龄儿）的截断点较高，男孩在第36至42周较高。将我们的截断点应用于该人群，识别出的低出生体重婴儿比之前应用的标准多47%。