Evaluation of the relationship between birth weight percentiles and perinatal outcomes in uncomplicated term pregnant women with large birth weight according to gestational age

Year 2020, Volume: 45 Issue: 1, 195 - 199, 31.03.2020

İlknur Çöl Madendağ , Mefkure Eraslan Şahin

https://doi.org/10.17826/cumj.635414

Cited By: 1

Abstract

Purpose: The aim of this article is to investigate the effect of large birth weight (LGA) on adverse neonatal outcomes, especially on the effect of stillbirth. Yet another hypothesis is; Increased adverse neonatal outcomes of infants whose birth weight is close to 90th percentile, but less than 90% (90-80%). In this study, our aim is to investigate and compare the adverse neonatal outcomes of infants whose birth weight is 90-80 percentile and to gain morbidity and mortality rate in our country's literature.
Materials and Methods: A total of 7800 births and infant files were examined in a tertiary center within a year. A total of 3 groups were formed. 1) birth weight> 90% (LGA group), 2) birth weight 90-80% 3) birth weight 79-10% (control group). The comparison of maternal and neonatal outcomes between groups was made.
Results: A total of 4286 patients met the study criteria; 234 were in the LGA group, 356 in the 80-90 percentile group and 3696 in the control group. Maternal age and cesarean delivery rate were highest in LGA group. The rate of admission to the neonatal unit was much higher than in the control group, similar in the LGA and 80-90 percentile groups. Mechanical ventilation was higher in LGA and 80-90 percentile groups than in the control group. Neonatal sepsis, RDS and clavicle fracture rates were slightly higher in LGA and 80-90 percentile groups compared to control group, but this difference was not statistically significant.
Conclusion: It was found that neonates who are between 80-90 percentiles in terms of birth weight have high morbidity and need for neonatal intensive care.

Keywords

LGA, neonatal morbidity, neonatal mortality, large baby

Gebelik yaşına göre büyük doğum ağırlığı bulunan komplike olmayan term gebelerde doğum ağırlığı persentillerinin perinatal sonuçlar ile ilişkisinin değerlendirilmesi

Abstract

Amaç: Çalışmanın amacı büyük doğum ağırlığı (LGA) olan (gebelik yaşına göre doğum ağırlığı >%90) ve doğum ağırlığı 90 persentile yakın ancak altında (%90-80) olan olguların başta ölü doğum olmak üzere perinatal sonuçlarını araştırarak, bu verileri ülkemiz literatürüne kazandırmaktır.
Gereç ve Yöntem: Tersiyer bir merkezde bir yıllık sürede toplam 7800 doğum yapan hasta ve bebek dosyaları incelenerek yapılmıştır. Toplam 3 grup oluşturuldu. 1) doğum ağırlığı > %90 olanlar (LGA grubu), 2) doğum ağırlığı %90-%80 olanlar 3) doğum ağırlığı %79-%10 (kontrol grubu). Gruplar arasında maternal ve yenidoğan kötü sonuçları açısından karşılaştırma yapıldı.
Bulgular: Çalışmaya dışlanma kriterlerine göre hastalar seçildikten sonra toplam 4286 hasta dahil edildi. Hastaların 234’ü LGA, 356’sı %80-90 persentil grubunda ve 3696’sı kontrol grubundaydı. Maternal yaş ve sezaryen doğum oranı LGA grubunda en yüksekti. Yenidoğan ünitesine başvuru oranı LGA ve 80-90 persentil grubunda benzer olmak üzere kontrol grubundan çok daha yüksek idi. Mekanik ventilasyon LGA ve 80-90 persentil grubunda kontrol grubuna göre daha yüksekti. Yenidoğan sepsisi, RDS ve klavikula kırık oranları LGA ve 80-90 persentil grubunda kontrol grubuna göre hafif daha yüksekti fakat bu fark istatistiksel olarak anlamlı değildi.
Sonuç: Bu çalışma ile doğum kilosuna göre 80-90 persentil arasında olan yenidoğanlarında morbiditesinin yüksek olduğu ve yenidoğan yoğun bakım ihtiyacının fazla olduğu bulunmuştur. 

Keywords

LGA, neonatal morbidite, neonatal mortalite, iri bebek

References

• 1. Chatfield J; American College of Obstetricians and Gynecologists. ACOG issues guidelines on fetal macrosomia. Am Fam Physician 2001;64(1):169–70
• 2. Chauhan SP, Grobman WA, Gherman RA, et al. Suspicion and treatment of the macrosomic fetus: a review. AmJ Obstet Gynecol 2005;193(2):332–46
• 3. Boulet SL, Alexander GR, Salihu HM, Pass M.Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol 2003;188(5):1372–78
• 4. Mendez-Figueroa H, Truong VT, Pedroza C, Khan AM, Chauhan SP. Small-for-gestational-age infants among uncomplicated pregnancies at term: a secondary analysis of 9 Maternal-Fetal Medicine Units Network studies. Am J Obstet Gynecol 2016;215(5): 628.e1–628.e7
• 5. Chen HY, Chauhan SP, Ward TC, Mori N, Gass ET, Cisler RA. Aberrant fetal growth and early, late, and postneonatalmortality: an analysis of Milwaukee births, 1996-2007. Am J Obstet Gynecol 2011;204(3):261.e1–261.e10
• 6. Xu H, Simonet F, Luo ZC. Optimal birth weight percentile cut-offs in defining small- or large-for-gestational age. Acta Paediatr 2010; 99:550
• 7. Martin JA, Hamilton BE, Sutton PD, et al. Births: Final Data for 2006. Natl Vital Stat Rep 2010; 59:1. http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_01.pdf (Accessed on October 26, 2011).
• 8. Alexander GR, Kogan MD, Himes JH. 1994-1996 U.S. singleton birth weight percentiles for gestational age by race, Hispanic origin, and gender. Maternal and child health journal. 1999;3(4):225-31.
• 9. Gümüş İİ, Karakurt F, Kargili A, Turhan NÖ, Uyar ME. Association between prepregnancy body mass index, gestational weight gain, and perinatal outcomes. Turkish Journal of Medical Sciences 2010;40(3):365-70.
• 10. Karatekin G, Salihoğlu Ö, Cantürk G, Okan F, Nuhoğlu A. Makrosomik Bebek İnsidansı ve Risk Faktörleri. Şişli Etfal Tıp Bülteni 2001;35(3):16-8.
• 11. Lam MH, Wong GY, Lao TT. Reappraisal of neonatal clavicular fracture: relationship between infant size and neonatal morbidity. Obstet Gynecol 2002; 100:115.
• 12. Persson M, Pasupathy D, Hanson U, Norman M. Disproportionate body composition and perinatal outcome in large-for-gestational-age infants to mothers with type 1 diabetes. BJOG. 2012;119(5):565-72.
• 13. John LB, Reddi Rani P, Ghose S. Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2017;6(8),:3587
• 14. Lackman F, Capewell V, Richardson B, et al. The risks of spontaneous preterm delivery and perinatal mortality in relation to size at birth according to fetal versus neonatal growth standards. Am J Obstet Gynecol 2001; 184:946.