Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
J Pediatr. 2018 Jul;198:174-180.e13. doi: 10.1016/j.jpeds.2018.02.042. Epub 2018 Apr 7.
To estimate the risks of mortality and morbidities in large for gestational age (LGA) infants relative to appropriate for gestational age infants born at 22-29 weeks of gestation.
Data on 156 587 infants were collected between 2006 and 2014 in 852 US centers participating in the Vermont Oxford Network. We defined LGA as sex-specific birth weight above the 90th centile for gestational age measured in days. Generalized additive models with smoothing splines on gestational age by LGA status were fitted on mortality and morbidity outcomes to estimate adjusted relative risks and their 95% CIs.
Compared with appropriate for gestational age infants, being born LGA was associated with decreased risks of mortality, respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, late-onset sepsis, severe retinopathy of prematurity, and chronic lung disease. Early onset sepsis and severe intraventricular hemorrhage were increased among LGA infants, but these risks were not homogeneous across the gestational age range.
Being born LGA was associated with lower risks for all the examined outcomes except for early onset sepsis and severe intraventricular hemorrhage.
评估相对于孕龄适当的 22-29 孕周出生婴儿，巨大儿（LGA）婴儿的死亡率和发病率风险。
2006 年至 2014 年期间，852 个美国中心参与了佛蒙特牛津网络研究，共收集了 156587 名婴儿的数据。我们将 LGA 定义为按孕龄以天数衡量的特定性别出生体重位于第 90 百分位数以上。通过 LGA 状态对胎龄进行平滑样条广义加性模型拟合，以估计调整后的相对风险及其 95%置信区间。
与孕龄适当的婴儿相比，出生时为 LGA 与死亡率、呼吸窘迫综合征、动脉导管未闭、坏死性小肠结肠炎、晚发性败血症、严重早产儿视网膜病变和慢性肺病的风险降低相关。LGA 婴儿的早发性败血症和严重脑室内出血风险增加，但这些风险在整个孕龄范围内并不均匀。
除早发性败血症和严重脑室内出血外，LGA 出生与所有检查结果的风险降低相关。
