Kaymak Didem, Beyoglu Oruc Simge Berrak
Department of Obstetric and Gynecology, Division of Perinatology, İstanbul Education and Research Hospital, İstanbul, Türkiye.
Department of Obstetric and Gynecology, Medical Park Göztepe Hospital, Bahçeşehir University School of Medicine, İstanbul, Türkiye.
Turk Arch Pediatr. 2025 Jul 1;60(4):419-425. doi: 10.5152/TurkArchPediatr.2025.25106.
Objective: This study aimed to investigate the impact of moderate altitude on neonatal birth weight and growth percentiles at term by controlling for major maternal and fetal risk factors. Materials and Methods: A retrospective, comparative, cross-sectional study was conducted in 2 geographically distinct regions of Türkiye: İstanbul (sea level, 31 m) and Ağrı (moderate altitude, ~1690 m). Pregnant women who delivered at term without comorbidities were included. Maternal demographic and first-trimester hemoglobin and hematocrit levels and neonatal outcomes were collected. Altitude-adjusted hemoglobin values were calculated, and statistical comparisons and multivariate regression analyses were performed. Results: A total of 156 women were included, with 75 in the low-altitude group and 81 in the high-altitude group. Although gestational age did not differ significantly, neonates at high altitude had significantly lower birth weights (3117 ± 424 g vs. 3351 ± 402 g, P < .001) and birth weight percentiles (39.9 ± 27.3 vs. 55.6 ± 26.9, P < .001). In the multivariate linear regression model (F= 6.16, P < .001), male sex and high-altitude residence were independently associated with birth weight percentile (β= +12.88, P =.003, β= -16.05, P = .002). In the high-altitude group, higher maternal hemoglobin levels were independently associated with a lower risk of small-for-gestational-age births (odds ratio [OR] = 0.56, 95% CI: 0.32-0.97, P= .040). Conclusion: Even at moderate altitudes, significant differences in fetal growth outcomes exist, independent of maternal comorbidities. These findings support the need for region-specific growth standards and altitude-aware perinatal surveillance.
本研究旨在通过控制主要的母体和胎儿风险因素，探讨中度海拔对足月新生儿出生体重和生长百分位数的影响。材料与方法：在土耳其两个地理位置不同的地区开展了一项回顾性、对比性横断面研究：伊斯坦布尔（海平面，31米）和阿格里（中度海拔，约1690米）。纳入了足月分娩且无合并症的孕妇。收集了产妇的人口统计学数据、孕早期血红蛋白和血细胞比容水平以及新生儿结局。计算了海拔校正后的血红蛋白值，并进行了统计比较和多因素回归分析。结果：共纳入156名女性，低海拔组75名，高海拔组81名。尽管孕周差异不显著，但高海拔地区的新生儿出生体重显著更低（3117±424克对3351±402克，P<.001），出生体重百分位数也显著更低（39.9±27.3对55.6±26.9，P<.001）。在多因素线性回归模型中（F = 6.16，P<.001），男性性别和高海拔居住与出生体重百分位数独立相关（β = +12.88，P =.003，β = -16.05，P =.002）。在高海拔组中，较高的母体血红蛋白水平与小于胎龄儿出生风险较低独立相关（比值比[OR] = （此处原文有误，应为0.5）6，95%置信区间：0.32 - 0.97，P =.040）。结论：即使在中度海拔地区，胎儿生长结局也存在显著差异，且与母体合并症无关。这些发现支持制定特定地区的生长标准以及开展有海拔意识的围产期监测的必要性。
