Chang Jui-Chun, Chen Yen-Ju, Chen I-Chieh, Lin Wei-Szu, Lin Ching-Tsai, Lin Ying-Cheng, Chen Yi-Ming, Lin Ching-Heng
Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan.
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Sci Rep. 2024 Dec 3;14(1):30123. doi: 10.1038/s41598-024-78834-0.
Prescriptive BW charts can facilitate discrimination between normal and abnormal birthweight. This study aimed to develop a prescriptive BW chart specific to Asian populations and assess its utility in predicting infant mortality. A retrospective cohort study was conducted using data from Taiwan National Health Insurance Research Database and National Birth Reporting Database. This study included 2 956 475 live-born singleton infants born to healthy mothers with uncomplicated pregnancies in Taiwan from January 1, 2004, to December 31, 2019. BW percentiles were estimated from GA 24-42 weeks by ranking the data in ascending order and calculating the percentile values based on the relative position of each observation within the dataset. Infant mortality rates were calculated for different GA groups, and optimal BW percentile cutoffs for predicting mortality were determined. A total of 2,255,989 infants (77.6%) from low-risk pregnancies were included in the development of the BW chart. Sex-specific BW percentiles were calculated. Optimal cutoff for predicting mortality were identified as follows: below the 22nd percentile or above the 96th percentile for extremely preterm infants (GA: 24-27 + 6 weeks), below the 11th percentile or above the 98th percentile for very preterm infants (GA: 28-31 + 6 weeks), below the 9th percentile or above the 99th percentile for moderately preterm infants (GA: 32-33 + 6 weeks), below the 8th percentile or above the 98th percentile for late preterm infants (GA: 34-36 + 6 weeks), and below the 7th percentile or above the 100th percentile for term infants (GA: > 37 weeks). A prescriptive BW chart was developed using data from a large population of Asian infants from low-risk pregnancies. BW percentiles were determined to predict infant mortality. Clinicians can utilize this approach to provide effective consultations to parents and improve decision-making processes.
规范性出生体重（BW）图表有助于区分正常和异常出生体重。本研究旨在开发一种针对亚洲人群的规范性BW图表，并评估其在预测婴儿死亡率方面的效用。利用台湾国民健康保险研究数据库和国家出生报告数据库的数据进行了一项回顾性队列研究。本研究纳入了2956475例于2004年1月1日至2019年12月31日在台湾出生的、母亲健康且妊娠无并发症的单胎活产婴儿。通过将数据按升序排列，并根据数据集中每个观察值的相对位置计算百分位数，从孕24 - 42周估计BW百分位数。计算不同孕周组的婴儿死亡率，并确定预测死亡率的最佳BW百分位数临界值。在BW图表的制定过程中，共纳入了2255989例来自低风险妊娠的婴儿（77.6%）。计算了按性别划分的BW百分位数。确定的预测死亡率的最佳临界值如下：极早产儿（孕周：24 - 27⁺⁶周）低于第22百分位数或高于第96百分位数，极早早产儿（孕周：28 - 31⁺⁶周）低于第11百分位数或高于第98百分位数，中度早产儿（孕周：32 - 33⁺⁶周）低于第9百分位数或高于第99百分位数，晚期早产儿（孕周：34 - 36⁺⁶周）低于第8百分位数或高于第98百分位数，足月儿（孕周：>37周）低于第7百分位数或高于第100百分位数。利用来自大量低风险妊娠亚洲婴儿的数据开发了一种规范性BW图表。确定BW百分位数以预测婴儿死亡率。临床医生可以利用这种方法为家长提供有效的咨询，并改善决策过程。
