Revollo Gabriela B, Martínez Jorge I, Grandi Carlos, Alfaro Emma L, Dipierri José E
Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Jujuy (UNJu), Instituto de Biología de la Altura (INBIAL), San Salvador de Jujuy.
Fac. Medicina, Univ. San Pablo, Brasil.
Arch Argent Pediatr. 2017 Dec 1;115(6):547-555. doi: 10.5546/aap.2017.eng.547.
The term “low birth weight” (< 2500 g) encompasses preterm newborns and term newborns small for gestational age (SGA) (< P10). The World Health Organization de nes underweight as a birth weight < P3 of weight/ age. There is no consensus at an international level about which standards and/or references related to birth weight for gestational age (GA) should be used to assess SGA and underweight among preterm newborns. Underweight and SGA prevalence was determined using the INTERGROWTH-21st standard and Urquía’s reference for the Argentine population, and agreement between the prevalence observed with both tools was analyzed.
Observational, analytical, and retrospective study based on all births occurred in 2013 as reported by the Argentine National Ministry of Health. Exclusion criteria were GA < 24+0 - > 42+6 weeks, twin pregnancy, and missing data on weight, GA, and sex. Prevalence was estimated by sex, region, and prematurity category for underweight and SGA according to the standard and the reference. Agreement was assessed using the Kappa index.
The prevalence of underweight and SGA was higher according to the standard among preterm newborns; the contrary was observed among full-term newborns. Statistical signi cance varied based on GA category, sex, and region. A higher prevalence was observed in the northern regions of Argentina, and agreement among prevalence values ranged from weak to very good.
Prevalence agreement of underweight and SGA observed according to the standard and the reference among preterm and full-term newborn infants was moderate, with interregional variability. Results propose new auxological perspectives in the epidemiological assessment of intrauterine growth restriction in Argentina.
“低出生体重”(<2500克)涵盖早产新生儿和小于胎龄(SGA)(<第10百分位数)的足月儿。世界卫生组织将低体重定义为出生体重<体重/年龄的第3百分位数。在国际层面,对于应使用哪些与胎龄(GA)出生体重相关的标准和/或参考值来评估早产新生儿中的SGA和低体重,尚无共识。使用INTERGROWTH-21标准和阿根廷人群的乌尔基亚参考值来确定低体重和SGA的患病率,并分析两种工具观察到的患病率之间的一致性。
基于阿根廷国家卫生部报告的2013年所有出生情况进行观察性、分析性和回顾性研究。排除标准为GA<24+0 - >42+6周、双胎妊娠以及体重、GA和性别的数据缺失。根据标准和参考值,按性别、地区和早产类别估计低体重和SGA的患病率。使用Kappa指数评估一致性。
根据标准,早产新生儿中低体重和SGA的患病率更高;足月儿中则相反。统计学显著性因GA类别、性别和地区而异。在阿根廷北部地区观察到更高的患病率,患病率值之间的一致性从弱到非常好不等。
根据标准和参考值观察到的早产和足月儿中低体重和SGA的患病率一致性为中等,存在区域间差异。结果为阿根廷宫内生长受限的流行病学评估提出了新的人体测量学观点。