Morkuniene Ruta, Cole Tim J, Jakimaviciene Egle Marija, Bankauskiene Agne, Isakova Jelena, Drazdiene Nijole, Basys Vytautas, Tutkuviene Janina
Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Front Pediatr. 2023 Jun 14;11:1173685. doi: 10.3389/fped.2023.1173685. eCollection 2023.
There is no global consensus as to which standards are the most appropriate for the assessment of birth weight and length. The study aimed to compare the applicability of regional and global standards to the Lithuanian newborn population by sex and gestational age, based on the prevalence of small or large for gestational age (SGA/LGA).
Analysis was performed on neonatal length and weight data obtained from the Lithuanian Medical Birth Register from 1995 to 2015 (618,235 newborns of 24-42 gestational weeks). Their distributions by gestation and sex were estimated using generalized additive models for location, scale, and shape (GAMLSS), and the results were compared with the INTERGROWTH-21st (IG-21) standard to evaluate the prevalence of SGA/LGA (10th/90th centile) at different gestational ages.
The difference in median length at term between the local reference and IG-21 was 3 cm-4 cm, while median weight at term differed by 200 g. The Lithuanian median weight at term was higher than in IG-21 by a full centile channel width, while the median length at term was higher by two channel widths. Based on the regional reference, the prevalence rates of SGA/LGA were 9.7%/10.1% for boys and 10.1%/9.9% for girls, close to the nominal 10%. Conversely, based on IG-21, the prevalence of SGA in boys/girls was less than half (4.1%/4.4%), while the prevalence of LGA was double (20.7%/19.1%).
Regional population-based neonatal references represent Lithuanian neonatal weight and length much more accurately than the global standard IG-21 which provides the prevalence rates for SGA/LGA that differ from the true values by a factor of two.
对于评估出生体重和身长而言，哪种标准最为合适，全球尚无共识。本研究旨在根据小于或大于胎龄儿（SGA/LGA）的患病率，比较区域和全球标准在立陶宛新生儿群体中按性别和胎龄的适用性。
对1995年至2015年从立陶宛医学出生登记处获得的新生儿身长和体重数据进行分析（618,235例孕24 - 42周的新生儿）。使用位置、尺度和形状的广义相加模型（GAMLSS）估计其按孕周和性别的分布，并将结果与INTERGROWTH-21st（IG-21）标准进行比较，以评估不同孕周时SGA/LGA（第10/90百分位数）的患病率。
本地参考标准与IG-21在足月时的身长中位数差异为3厘米 - 4厘米，而足月时的体重中位数差异为200克。立陶宛足月时的体重中位数比IG-21高出整整一个百分位数通道宽度，而足月时的身长中位数高出两个通道宽度。基于区域参考标准，男孩和女孩的SGA/LGA患病率分别为9.7%/10.1%和10.1%/9.9%，接近标称的10%。相反，基于IG-21，男孩/女孩中SGA的患病率不到一半（4.1%/4.4%），而LGA的患病率则翻倍（20.7%/19.1%）。
基于区域人群的新生儿参考标准比全球标准IG-21更准确地反映了立陶宛新生儿的体重和身长，IG-21提供的SGA/LGA患病率与真实值相差两倍。
