General Obstetrics and Gynecology: ObstetricsFetal growth risk curves: Defining levels of fetal growth restriction by neonatal death risk
Section snippets
Material and methods
The data for this study were derived from the National Center for Health Statistics linked live birth/infant death cohort files. The project was reviewed by the University of Alabama at Birmingham's Institutional Review Boards for Human Use and qualified for exempt review. Single gestation infants who were born to US resident mothers from 1996 to 2000 with reported gestational age values of 25 to 42 weeks were included in this analysis. Gestational age in completed weeks was computed from the
Results
Table I depicts the ratio of the neonatal mortality rate at selected birth weight percentiles relative to the average neonatal mortality rate for the 45th to 55th percentiles for gestational ages of 25 to 42 weeks. The rate ratios varied across birth weight percentiles and gestation. For example at 26 weeks of gestation, infants at the 10th percentile of birth weight for gestational age experienced a 3-fold risk of dying within the first 28 days of life (relative to the “normal” comparison
Comment
An important limitation of the current method of defining SGA is the lack of a reference to the level of neonatal death risk that the 10th percentile of birth weight might entail at each gestational age. Although current SGA birth weight thresholds permit the identification of infants whose risk for an adverse outcome may be greater than appropriately grown infants, the relative increases in risk are not enumerated. In addition, the differential in risk between SGA and average-for-gestational
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Supported in part by Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau grants: T03MC00007 and MCJ009040.