González López Clara, Solís Sánchez Gonzalo, Fernández Colomer Belén, Mantecón Fernández Laura, Lareu Vidal Sonia, Fernández Castiñeira Sara, Rubio Granda Ana, Pérez Pérez Alicia, Suárez Rodríguez Marta
Servicio de Neonatología, Área de Gestión Clínica de la Infancia y Adolescencia, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto Investigación Sanitaria Principado de Asturias, ISPA, 33011 Oviedo, Spain.
Children (Basel). 2024 Jul 31;11(8):934. doi: 10.3390/children11080934.
Variable diagnostic criteria and growth charts have been used for extrauterine growth restriction (EUGR). The objective was to assess the prevalence and concordance of EUGR in extremely-low-birthweight (ELBW) infants with the most frequent diagnostic criteria and growth charts.
An observational, retrospective and multicenter study was conducted from 2011 to 2020 including ELBW infants from the Spanish SEN1500 Network. EUGR prevalence was calculated at discharge using different definitions: cross-sectional (anthropometry less than the 10th centile), longitudinal (decrease of more than 1 SD from birth to discharge), "true" cross-sectional and "true" longitudinal (using the criteria previously described, excluding infants small for gestational age at birth). Concordance among Fenton, Olsen and INTERGROWTH-21st was assessed with Fleiss' Kappa coefficient.
The prevalence of EUGR was variable with the different definitions and growth references studied in the 7914 ELBW infants included. Overall, it was higher with Fenton for all the EUGR criteria studied by weight and length. The agreement among growth charts was substantial (κ > 0.6) for all the definitions except for longitudinal EUGR by weight (moderate, κ = 0.578).
The prevalence of EUGR was variable in our cohort with the different diagnostic criteria and growth charts. The agreement among charts was good for all the definitions of EUGR except longitudinal EUGR by weight.
宫外生长受限（EUGR）采用了多种诊断标准和生长图表。目的是使用最常用的诊断标准和生长图表评估极低出生体重（ELBW）婴儿中EUGR的患病率及一致性。
2011年至2020年进行了一项观察性、回顾性多中心研究，纳入了西班牙SEN1500网络中的ELBW婴儿。出院时使用不同定义计算EUGR患病率：横断面（人体测量值低于第10百分位数）、纵向（从出生到出院下降超过1个标准差）、“真正的”横断面和“真正的”纵向（使用先前描述的标准，排除出生时小于胎龄的婴儿）。使用Fleiss卡方系数评估Fenton、Olsen和INTERGROWTH-21st之间的一致性。
在纳入的7914例ELBW婴儿中，EUGR患病率因所研究的不同定义和生长参考值而异。总体而言，就体重和身长所研究的所有EUGR标准而言，Fenton标准下的患病率更高。除体重纵向EUGR（中等一致性，κ = 0.578）外，所有定义的生长图表之间的一致性都很强（κ > 0.6）。
在我们的队列中，不同诊断标准和生长图表下EUGR的患病率各不相同。除体重纵向EUGR外，所有EUGR定义的图表之间一致性良好。
