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从危地马拉高地社区的观察到的产后体重估算出生体重。

Estimating birth weight from observed postnatal weights in a Guatemalan highland community.

机构信息

Department of Biomedical Informatics, Emory University, Atlanta, GA, United States of America.

出版信息

Physiol Meas. 2020 Mar 6;41(2):025008. doi: 10.1088/1361-6579/ab7350.

Abstract

OBJECTIVE

Low birth weight is one of the leading contributors to global perinatal deaths. Detecting this problem close to birth enables the initiation of early intervention, thus reducing the long-term impact on the fetus. However, in low-and middle-income countries, sometimes newborns are weighted days or months after birth, thus challenging the identification of low birth weight. This study aims to estimate birth weight from observed postnatal weights recorded in a Guatemalan highland community.

APPROACH

With 918 newborns recorded in postpartum visits at a Guatemalan highland community, we fitted traditional infant weight models (Count's and Reeds models). The model that fitted the observed data best was selected based on typical newborn weight patterns reported in the medical literature and previous longitudinal studies. Then, estimated birth weights were determined using the weight gain percentage derived from the fitted weight curve.

MAIN RESULTS

The best model for both genders was the Reeds2 model, with a mean square error of 0.30 kg and 0.23 kg for male and female newborns, respectively. The fitted weight curves exhibited similar behavior to those reported in the literature, with a maximum weight loss around three to five days after birth, and birth weight recovery, on average, by day ten. Moreover, the estimated birth weight was consistent with the 2015 Guatemalan National Survey, no having a statistically significant difference between the estimated birth weight and the reported survey birth weights (two-sided Wilcoxon rank-sum test; [Formula: see text]).

SIGNIFICANCE

By estimating birth weight at an opportune time, several days after birth, it may be possible to identify low birth weight more accurately, thus providing timely treatment when is required.

摘要

目的

低出生体重是全球围产期死亡的主要原因之一。在接近分娩时发现这个问题,可以启动早期干预,从而减少对胎儿的长期影响。然而,在中低收入国家,有时新生儿在出生后几天或几个月才称重,因此难以识别低出生体重。本研究旨在根据危地马拉高地社区产后访视中记录的观察到的新生儿体重来估计出生体重。

方法

在危地马拉高地社区的产后访视中记录了 918 名新生儿,我们拟合了传统的婴儿体重模型(Count's 和 Reeds 模型)。根据医学文献和先前的纵向研究中报告的典型新生儿体重模式,选择最适合观察到的数据的模型。然后,使用从拟合体重曲线中得出的体重增加百分比来确定估计的出生体重。

主要结果

对于男性和女性新生儿,最佳模型均为 Reeds2 模型,其均方误差分别为 0.30 公斤和 0.23 公斤。拟合的体重曲线表现出与文献中报告的相似行为,出生后三到五天左右体重最大损失,平均在第十天恢复出生体重。此外,估计的出生体重与 2015 年危地马拉国家调查一致,估计的出生体重与报告的调查出生体重之间没有统计学上的显著差异(双侧 Wilcoxon 秩和检验;[公式:见文本])。

意义

通过在出生后几天的适当时间估计出生体重,可能可以更准确地识别低出生体重,从而在需要时及时进行治疗。

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本文引用的文献

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Weight Change Nomograms for the First Month After Birth.出生后第一个月的体重变化列线图。
Pediatrics. 2016 Dec;138(6). doi: 10.1542/peds.2016-2625. Epub 2016 Nov 9.

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