Premru-Srsen Tanja, Verdenik Ivan, Mihevc Ponikvar Barbara, Hugh Oliver, Francis Andre, Gardosi Jason
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
National Institute of Public Health, Ljubljana, Slovenia.
J Perinat Med. 2019 Apr 24;47(3):270-275. doi: 10.1515/jpm-2018-0219.
Objective To produce a customised birthweight standard for Slovenia. Methods This retrospective study used a cohort from the National Perinatal Information System of Slovenia (NPIS). Prospectively collected information from pregnancies delivered in all of Slovenia's 14 maternal hospitals between 1st January 2003 and 31st December 2012 was included. Coefficients were derived using a backward stepwise multiple regression technique. Results A total of 126,627 consecutive deliveries with complete data were included in the multivariable analysis. Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as physiological variables, with coefficients comparable to findings in other countries. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3451.3 g. Pathological influences on birthweight within this population included low and high maternal age, low and high body mass index (BMI), smoking, pre-existing and gestational diabetes and pre-existing and gestational hypertension. Conclusion The analysis confirmed the main physiological variables that affect birthweight in studies from other countries, and was able to quantify additional pathological factors of maternal age and gestational diabetes. Development of a country-specific customised birthweight standard will aid clinicians in Slovenia with the distinction between normal and abnormal small-for-gestational age (SGA) fetuses, thus avoiding unnecessary interventions and improving identification of at risk pregnancies, and long-term outcomes for infants.
目的 制定斯洛文尼亚的定制出生体重标准。方法 这项回顾性研究使用了斯洛文尼亚国家围产期信息系统(NPIS)的一个队列。纳入了2003年1月1日至2012年12月31日期间在斯洛文尼亚所有14家妇产医院分娩的前瞻性收集的妊娠信息。使用向后逐步多元回归技术得出系数。结果 多变量分析纳入了总共126,627例有完整数据的连续分娩。产妇身高、孕早期体重、产次以及婴儿性别被确定为生理变量,其系数与其他国家的研究结果相当。标准身材母亲(身高163厘米,体重64千克)首次怀孕时,不受病理影响的预期280天出生体重为3451.3克。该人群中对出生体重的病理影响包括产妇年龄过低和过高、体重指数(BMI)过低和过高、吸烟、孕前和孕期糖尿病以及孕前和孕期高血压。结论 该分析证实了其他国家研究中影响出生体重的主要生理变量,并能够量化产妇年龄和孕期糖尿病等额外的病理因素。制定针对特定国家的定制出生体重标准将有助于斯洛文尼亚的临床医生区分正常和异常的小于胎龄(SGA)胎儿,从而避免不必要的干预,改善对高危妊娠的识别以及婴儿的长期结局。