美国新生儿重症监护室婴儿按出生体型分类的死亡率风险,比较三种生长曲线。

Neonatology Pub Date : 2024-04-15 DOI:10.1159/000536180
A. N. Ferguson, Marion Granger, I. Olsen, Reese H Clark, Jessica G Woo
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引用次数: 0

摘要

引言三条广泛引用的生长曲线将婴儿出生时的人体测量值分为小胎龄(SGA)、适龄(AGA)或大胎龄(LGA),但它们的分类方法各不相同。我们评估了这些分类差异对美国早产儿新生儿重症监护室(NICU)死亡风险的识别和预测有何影响。方法分析了Pediatrix临床数据仓库(2013-2018年)中新生儿重症监护室收治的婴儿出生数据。采用Olsen、Fenton和INTERGROWTH-21st曲线将46724名单胎婴儿(体重24-32周)的出生体重、身长和头围分为SGA、AGA或LGA。结果与 AGA 婴儿相比,在所有 GA、体型测量和曲线组中,SGA 分类婴儿的死亡率均有所增加。体重为 LGA 的婴儿在孕期 24 周时死亡风险较低,而在孕期 30 周时死亡风险较高。不同曲线组的死亡几率差异不大。结论不同曲线组在预测死亡率方面没有显著差异。出生时体型分类是一种相对不精确的方法,用于识别新生儿重症监护室死亡风险婴儿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mortality Risk in US Neonatal Intensive Care Unit Infants by Birth Size Classifications Comparing Three Growth Curves.
INTRODUCTION Three widely referenced growth curves classify infant birth anthropometric measurements as small (SGA), appropriate (AGA), or large (LGA) for gestational age (GA) differently. We assessed how these differences in assignment affect the identification and prediction of neonatal intensive care unit (NICU) mortality risk in US preterm infants. METHODS Birth data of infants admitted to NICUs from the Pediatrix Clinical Data Warehouse (2013-2018) were analyzed. Birth weight, length, and head circumference of 46,724 singleton infants (24-32 weeks GA) were classified as SGA, AGA, or LGA using the Olsen, Fenton, and INTERGROWTH-21st curves. NICU mortality risk based on birth size classification was analyzed using unadjusted and adjusted logistic regression stratified by GA. RESULTS Odds of mortality were increased with SGA classification at all GAs, size measurements, and curve sets, compared with AGA infants. LGA classification for weight was associated with lower mortality risk at 24 weeks GA and higher risk at 30 weeks GA. Odds of mortality did not differ significantly across curve sets. Classification of size at birth alone had relatively low predictive ability to identify mortality risk, with unadjusted AUCs near 0.5 for all analyses. CONCLUSION There were no significant differences across curve sets in predicting mortality. Classification of size at birth is a relatively imprecise method to identify infants at risk for NICU mortality.
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