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新的澳大利亚出生体重百分位数。

New Australian birthweight centiles.

机构信息

Royal Prince Alfred Hospital, Sydney, NSW.

Sydney Institute for Women, Children and their Families, Sydney, NSW.

出版信息

Med J Aust. 2020 Jul;213(2):79-85. doi: 10.5694/mja2.50676. Epub 2020 Jun 30.

Abstract

OBJECTIVES

To prepare more accurate population-based Australian birthweight centile charts by using the most recent population data available and by excluding pre-term deliveries by obstetric intervention of small for gestational age babies.

DESIGN

Population-based retrospective observational study.

SETTING

Australian Institute of Health and Welfare National Perinatal Data Collection.

PARTICIPANTS

All singleton births in Australia of 23-42 completed weeks' gestation and with spontaneous onset of labour, 2004-2013. Births initiated by obstetric intervention were excluded to minimise the influence of decisions to deliver small for gestational age babies before term.

MAIN OUTCOME MEASURES

Birthweight centile curves, by gestational age and sex.

RESULTS

Gestational age, birthweight, sex, and labour onset data were available for 2 807 051 singleton live births; onset of labour was spontaneous for 1 582 137 births (56.4%). At pre-term gestational ages, the 10th centile was higher than the corresponding centile in previous Australian birthweight charts based upon all births.

CONCLUSION

Current birthweight centile charts probably underestimate the incidence of intra-uterine growth restriction because obstetric interventions for delivering pre-term small for gestational age babies depress the curves at earlier gestational ages. Our curves circumvent this problem by excluding intervention-initiated births; they also incorporate more recent population data. These updated centile curves could facilitate more accurate diagnosis of small for gestational age babies in Australia.

摘要

目的

利用最新的可用人口数据并排除因产科干预而早产的小于胎龄儿,来制定更准确的基于人群的澳大利亚出生体重百分位数图表。

设计

基于人群的回顾性观察研究。

地点

澳大利亚卫生和福利研究所国家围产期数据收集。

参与者

2004 年至 2013 年间,澳大利亚所有 23-42 周完整妊娠且自发性临产的单胎分娩,排除因产科干预而启动的分娩,以尽量减少在足月前分娩小于胎龄儿的决策的影响。

主要观察指标

按胎龄和性别划分的出生体重百分位数曲线。

结果

有 2807051 例单胎活产的胎龄、出生体重、性别和临产数据可用;1582137 例(56.4%)为自发性临产。在早产胎龄时,第 10 个百分位数高于之前所有出生的澳大利亚出生体重图表中相应的百分位数。

结论

目前的出生体重百分位数图表可能低估了宫内生长受限的发生率,因为因产科干预而早产的小于胎龄儿会使更早的胎龄曲线下降。我们的曲线通过排除因产科干预而启动的分娩来规避这个问题;它们还纳入了更近期的人口数据。这些更新的百分位数曲线可以促进澳大利亚更准确地诊断小于胎龄儿。

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