Goldenberg R L, Cutter G R, Hoffman H J, Foster J M, Nelson K G, Hauth J C
Department of Obstetrics and Gynecology, University of Alabama, Birmingham 35294.
Am J Obstet Gynecol. 1989 Aug;161(2):271-7. doi: 10.1016/0002-9378(89)90497-3.
An intrauterine growth-retarded infant is commonly defined as one weighing less than the 10th percentile in birth weight for its gestational age. However, because there is no standard population from which to derive these percentiles, the birth weights that serve as the cutoff point in various published studies may differ by several hundred grams at any gestational age. For this reason, we examined the studies from which the currently used 10th-percentile standards are derived to determine which factors may be responsible for the variation. In addition to obvious differences in the populations and geographic areas on which they were based, studies differed in how gestational age was determined, whether the gestational age was "rounded" or given in completed weeks, which types of infants were excluded, whether the studies were hospital or population based, and whether they were controlled for sex of the infant and race and parity of the mother. These differences in study methodology may be as or more important than the population differences in defining the 10th percentile cutoffs. A single national standard for intrauterine growth retardation would allow comparison between studies of risk factors, diagnostic tests, management, and long-term follow-up status of fetuses and infants with intrauterine growth retardation.
宫内生长迟缓儿通常被定义为出生体重低于其孕龄对应的出生体重第10百分位数的婴儿。然而，由于没有可从中得出这些百分位数的标准人群，在不同已发表研究中用作截断点的出生体重在任何孕龄时都可能相差数百克。因此，我们检查了得出当前使用的第10百分位数标准的研究，以确定哪些因素可能导致了这种差异。除了所基于的人群和地理区域存在明显差异外，各研究在孕龄的确定方式、孕龄是“四舍五入”还是以完整周数给出、排除了哪些类型的婴儿、研究是基于医院还是基于人群，以及是否对婴儿性别、母亲种族和产次进行了控制等方面也存在差异。在定义第10百分位数截断点时，研究方法上的这些差异可能与人群差异同样重要或更重要。宫内生长迟缓的单一国家标准将有助于比较有关宫内生长迟缓胎儿和婴儿的危险因素、诊断测试、管理及长期随访状况的研究。
