Birth-weight centiles and the risk of serious adverse neonatal outcomes at term

Abstract Background: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences. Aim: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies. Materials and methods: This was a retrospective cohort study of singleton term births at the Mater Mother’s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤−12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile. Results: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06–4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30–1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60–7.75). Conclusions: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.

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Peri-intraventricular hemorrhage in newborns weighing less than 1500 grams: comparative analysis between 2 institutions

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812003000600002 ◽

2003 ◽

Vol 58 (6) ◽

pp. 299-304

Author(s):

Marinice Duarte da Ponte ◽

Sérgio Tadeu Martins Marba

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

World Literature ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Maternity Hospital ◽

State University ◽

Gestational Age At Birth ◽

Age At Birth

PURPOSE: This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance. METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS: We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks. CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of peri-intraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.

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Does Fetal Gender Really Affects Neonatal Birth Weight and Gestational Age at Birth? A Prospective Cohort Study

International Journal of Childbirth ◽

10.1891/ijcbirth-d-19-00013 ◽

2019 ◽

Vol 9 (4) ◽

pp. 203-210

Author(s):

Naina Kumar ◽

Ashu Yadav

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Apgar Scores ◽

Fetal Gender ◽

Neonatal Birth Weight ◽

Tertiary Center ◽

Significant Difference ◽

Gestational Age At Birth ◽

The Impact ◽

Age At Birth

OBJECTIVEThe objective of this study was to understand the impact of fetal gender on neonatal birth weight for the gestational age at the time of birth. Only neonates with a gestational age of 28 weeks or more than 28 weeks were included in the study.METHODSThis prospective study was conducted within the Obstetrics and Gynecology Department of a rural tertiary center in Northern India. The study was conducted after ethical clearance and informed consent from participants who fulfilled the inclusion criteria. Data collection included neonatal gender, birth weight, Apgar scores, and gestational age. Neonates were delivered vaginally or by cesarean section at 28 or more weeks of gestation. Statistical analysis was done using version SPSS-22 software.RESULTSOf 2,997 live fetuses, 1,574 (52.5%) were male, 1,421 (47.4%) were female, and 2 (0.07%) had ambiguous genitalia. Mean ± standard deviation (SD) for male neonate's birth weight was 2.79 ± 0.503 kg (95% confidence interval [CI]: 2.76–2.81), for females 2.67 ± 0.485 kg (95% CI: 2.64–2.69) respectively (p = .000). Males had lower Apgar scores at 1 and 5 minutes of age compared to females (7.06 ± 0.859, 8.83 ± 0.838 vs. 7.12 ± 0.645, 8.88 ± 0.612). There were no significant difference between fetal gender and gestational age at birth (18% females were preterm vs. 15.4% males, 81.8% females were term vs. 84.2% males, 0.1% females post-term vs. 0.4% males; p = .079).CONCLUSIONFetal gender was related to birth weight. Male neonates had a higher birth weight, but lower Apgar scores than female neonates. Fetal gender was not correlated with gestational age at the time of birth.

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Time to Regain Birth Weight - A Marker to Predict the Severity of Retinopathy of Prematurity?

10.21203/rs.3.rs-719911/v1 ◽

2021 ◽

Author(s):

Ajay Anvekar ◽

Sam E Athikarisamy ◽

Shripada Rao ◽

Andy Gill ◽

Elizabeth A. Nathan ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Statistical Significance ◽

Area Under The Curve ◽

Uterine Growth ◽

Level 3 ◽

Gestational Age At Birth ◽

Age At Birth

Abstract Background: Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight be used as an additional marker to identify infants needing treatment for ROP.Methods: In this retrospective study, preterm infants (<27 weeks gestational age at birth) born during the period from 1/1/2010-31/12/2015 at a level 3 neonatal intensive care unit in Australia were included. 27 cases (ROP needing treatment) were identified. Controls (ROP not needing treatment or no ROP) were matched with cases on gestational age at birth and birthweight (1:4 ratio). Data were collected from the database and medical records.Results: The median (IQR) gestational age for cases and controls were 24 (24-26) and 25 (24-26) weeks respectively and median (IQR) birthweight for cases and controls were 675 (635-810) and 773 (666-884) grams respectively. Cases were more likely to be intra uterine growth restricted (18.5% vs 3.7%, p=0.015) and had increased weeks on oxygen (median 11.9 vs 9.1, p=0.028). Median (IQR) time to regain birth weight in cases and controls were 9 (6-13) and 7 (5-10) days respectively. Time to regain birthweight approached statistical significance when adjusted for duration of oxygen (aOR 1.08, 95% CI 1.00-1.17, p=0.054). The area under the curve from the time to regain BW ROC analysis with adjustment for IUGR and duration of oxygen was 0.73 (95% CI 0.62-0.83).Conclusion: Time to regain BW has potential to aid prediction of ROP needing treatment.

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Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

Twin Research and Human Genetics ◽

10.1375/twin.13.5.501 ◽

2010 ◽

Vol 13 (5) ◽

pp. 501-507 ◽

Cited By ~ 8

Author(s):

Ali Gedikbasi ◽

Alpaslan Akyol ◽

Gokhan Yildirim ◽

Ali Ekiz ◽

Ahmet Gul ◽

...

Keyword(s):

Gestational Age ◽

Statistical Significance ◽

Expectant Management ◽

Control Group ◽

Study Group ◽

Preliminary Evaluation ◽

Gestational Age At Birth ◽

The Impact ◽

Twin Pregnancies ◽

Age At Birth

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n= 429; 2137g and 34.71 weeks), DC study group,n= 37; 2117g (p= .338) and 33.97 weeks (p= .311), and DC study group with major malformations,n= 30; 2019g (p= .289) and 33.3 weeks (p= .01), and showed only significance for gestational age. There was no statistical significance between MC control group,n= 86; 2097g and 34.93 weeks, and MC study group,n= 18; 2237g (p= .338), and 34.42 weeks (p= .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

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Effects of gestational age at birth on perinatal structural brain development in healthy term-born babies

10.1101/2021.05.02.442327 ◽

2021 ◽

Author(s):

Oliver Gale-Grant ◽

Sunniva Fenn-Moltu ◽

Lucas Franca ◽

Ralica Dimitrova ◽

Daan Christiaens ◽

...

Keyword(s):

Linear Regression ◽

Gestational Age ◽

Neurodevelopmental Outcome ◽

Magnetic Resonance Images ◽

Linear Regression Models ◽

Early Term ◽

Gestational Age At Birth ◽

The Impact ◽

Age At Birth ◽

Structural Brain

Multiple studies have demonstrated less favourable childhood outcomes in infants born in early term (37-38 weeks gestation) compared to those born at full term (40-41 weeks gestation). While this could be due to lower birthweight and greater perinatal morbidity, gestational age at birth may also have a direct effect on the brain and subsequent neurodevelopment in term-born babies. Here we characterise structural brain correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome. We used T2 and diffusion weighted Magnetic Resonance Images acquired in the neonatal period from a cohort (n=454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor based morphometry (TBM) and tract based spatial statistics (TBSS). Neurodevelopment was subsequently assessed at age 18 months using the Bayley-III Scales of Infant and Toddler Development (n=281), and the effects of gestational age at birth and related neuroimaging findings on outcome were analysed with linear regression. Infants born earlier had areas of higher relative ventricular volume, and lower relative brain volume in the basal ganglia, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Linear regression models predicting outcome from gestational age at birth were significantly improved by adding neuroimaging features associated with gestational age at birth. This work adds to the growing body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.

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Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

Journal of Speech Language and Hearing Research ◽

10.1044/2018_jslhr-h-16-0291 ◽

2018 ◽

Vol 61 (7) ◽

pp. 1784-1793

Author(s):

Lilian Cássia Bórnia Jacob-Corteletti ◽

Eliene Silva Araújo ◽

Josilene Luciene Duarte ◽

Fernanda Zucki ◽

Kátia de Freitas Alvarenga

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Pure Tone ◽

Broadband Noise ◽

Acoustic Reflex ◽

Group I ◽

Group Ii ◽

Gestational Age At Birth ◽

Age At Birth

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

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Abstract P179: Neonatal Outcomes in Normal and Preeclamptic Pregnancies: A retrospective Comparative Study

Hypertension ◽

10.1161/hyp.68.suppl_1.p179 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Niraj Vora ◽

Ram R Kalagiri ◽

Venkata N Raju ◽

Nathan Drever ◽

Madhava R Beeram ◽

...

Keyword(s):

Birth Weight ◽

Hospital Stay ◽

Gestational Age ◽

Neonatal Intensive Care ◽

De Novo ◽

Length Of Hospital Stay ◽

Admission Rate ◽

Retrospective Chart Review ◽

Neonatal Outcomes ◽

Retrospective Comparative Study

Background: Preeclampsia (PreE), a de novo development of Hypertension in consort with proteinuria after 20 weeks of gestation is the leading cause of morbidity and mortality in mother and the offspring. It affects approximately 3-8% of overall pregnancies. Although, specific etiologies remain unknown, it has been supported by various studies that PreE is not just a single disorder, but a syndrome of pertinent multiple pathophysiological factors. Methods: An IRB approved retrospective chart review over a year (January 2014 to December 2014) was conducted of all pregnancies occurred at Baylor Scott and White Health System, Temple, Texas (N = 3704). We divided all pregnancies into two separate groups: PreE (N = 299) vs. Non PreE (N = 3405). We compared the neonatal outcomes between two groups including their offspring’s gestational age, birth weight, admission rate to Neonatal Intensive Care Unit (NICU), occurrence of bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), hypoglycemia, thrombocytopenia, intraventricular hemorrhage (IVH) and length of hospital stay (LOS). Results: We found amongst these two groups, infants born to PreE mothers have significantly lower birthweight (Mean = 2807 grams, SD = 841 grams) compared to Non PreE mothers (Mean = 3383 grams, SD = 619 grams) (P<0.05), significantly lower GA (Mean = 36.7 weeks, SD = 3.25 weeks) compared to Non PreE group (Mean = 38.7 weeks, SD = 2.1 weeks) (P<0.05), significantly higher rate of BPD (11%) compared to Non PreE group (6.9%)(P<0.05), significantly higher occurrence of hypoglycemia (26%) compared to non PreE group (20%) (P<0.05), significantly higher rate of thrombocytopenia (28%) compared to Non PreE group (17%) (P<0.05) and significantly higher length of hospital stay (Mean = 19 days, SD = 20 days) compared to Non PreE group (Mean = 14 days, SD = 20 days) (P<0.05). Conclusion: We can conclude from this retrospective analysis that infants born to PreE mothers have lower birth weight indicating the intrauterine growth restriction and the lower gestational age indicating preterm birth. Moreover, the data indicate the higher rate of BPD, hypoglycemia, thrombocytopenia and requirement of increased length of hospital stay in infants born to PreE mothers compared to Non PreE mothers.

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Developmental and Psychological Test Scores in Children of Low Birth Weight

PEDIATRICS ◽

10.1542/peds.45.5.886a ◽

1970 ◽

Vol 45 (5) ◽

pp. 886-887

Author(s):

Linda C. Eaves ◽

Harry Klonoff ◽

Henry G. Dunn

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Test Scores ◽

Personal Communication ◽

Psychological Test ◽

January Issue ◽

The Subject ◽

Gestational Age At Birth ◽

Age At Birth

In the printing of our article on the subject in the January issue of Pediatrics (45:9, 1970) the wording of a sentence on page 10 was unfortunately changed in such a manner as to distort the personal communication we had received from Dr. Ruth Griffiths in London, England. As printed, the sentence is: "It does not seem admirable to try and meaningful to correct such D.Q. figures according to gestational age at birth." The statement we wished to make was: "It does not seem advisable to try and correct such D.Q. figures according to gestational age at birth."

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High-Dose Erythropoietin in Extremely Low Gestational Age Neonates Does Not Alter Risk of Retinopathy of Prematurity

Neonatology ◽

10.1159/000511262 ◽

2020 ◽

pp. 1-8

Author(s):

Dennis E. Mayock ◽

Zimeng Xie ◽

Bryan A. Comstock ◽

Patrick J. Heagerty ◽

Sandra E. Juul ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

High Frequency ◽

High Dose ◽

Heart Murmur ◽

Treatment Groups ◽

Increased Risk ◽

Gestational Age At Birth ◽

Age At Birth

Introduction: The Preterm Erythropoietin (Epo) Neuroprotection (PENUT) Trial sought to determine the safety and efficacy of early high-dose Epo as a potential neuroprotective treatment. We hypothesized that Epo would not increase the incidence or severity of retinopathy of prematurity (ROP). Methods: A total of 941 infants born between 24–0/7 and 27–6/7 weeks’ gestation were randomized to 1,000 U/kg Epo or placebo intravenously for 6 doses, followed by subcutaneous or sham injections of 400 U/kg Epo 3 times a week through 32 weeks post-menstrual age. In this secondary analysis of PENUT trial data, survivors were evaluated for ROP. A modified intention-to-treat approach was used to compare treatment groups. In addition, risk factors for ROP were evaluated using regression methods that account for multiples and allow for adjustment for treatment and gestational age at birth. Results: Of 845 subjects who underwent ROP examination, 503 were diagnosed with ROP with similar incidence and severity between treatment groups. Gestational age at birth, birth weight, prenatal magnesium sulfate, maternal antibiotic exposure, and presence of heart murmur at 2 weeks predicted the development of any ROP, while being on high-frequency oscillator or high-frequency jet ventilation (HFOV/HFJV) at 2 weeks predicted severe ROP. Conclusion: Early high-dose Epo followed by maintenance dosing through 32 weeks does not increase the risk of any or severe ROP in extremely low gestational age neonates. Gestational age, birth weight, maternal treatment with magnesium sulfate, antibiotic use during pregnancy, and presence of a heart murmur at 2 weeks were associated with increased risk of any ROP. Treatment with HFOV/HFJV was associated with an increased risk of severe ROP.

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Treatment of 139 Pregnancies in Antiphospholipid-positive Women Not Fulfilling Criteria for Antiphospholipid Syndrome: A Retrospective Study

The Journal of Rheumatology ◽

10.3899/jrheum.120576 ◽

2013 ◽

Vol 40 (4) ◽

pp. 425-429 ◽

Cited By ~ 31

Author(s):

Teresa Del Ross ◽

Amelia Ruffatti ◽

Maria Serena Visentin ◽

Marta Tonello ◽

Antonia Calligaro ◽

...

Keyword(s):

Birth Weight ◽

Pregnancy Outcome ◽

Gestational Age ◽

Pregnancy Loss ◽

Antiphospholipid Antibody ◽

Birth Weight Percentile ◽

Antibody Profile ◽

Gestational Age At Birth ◽

Age At Birth ◽

Weight Percentile

Objective.The effect of low-dose aspirin (LDA) on pregnancy outcome in antiphospholipid (aPL)-positive women not fulfilling the criteria for antiphospholipid antibody syndrome (APS) was evaluated retrospectively.Methods.We evaluated 139 pregnancies of 114 aPL-positive women not fulfilling the Sydney classification criteria for definite APS (104 treated with LDA, 35 untreated). Inclusion criteria consisted of (1) any titer of aPL and no previous pregnancy or no pregnancy losses (defined as aPL carriers); (2) any titer of aPL and 1 or 2 pregnancy losses before the 10th gestational week. No women had previous thrombosis. The rate of pregnancy loss, gestational age at delivery, and birth weight percentile were compared in the treated and untreated patients. Associations between clinical and laboratory characteristics and pregnancy outcomes were investigated.Results.The rate of pregnancy loss was low in both treated and untreated groups (7.7% vs 2.9%, respectively). There were no statistically significant differences in the rate of pregnancy loss, gestational age at birth, or birth weight percentile in the treated and untreated groups. There were significant associations between gestational age at birth ≤ 34th week and positivity for lupus anticoagulant (p = 0.025) and anti-ß2-glycoprotein I IgG antibodies at titers > 99th (p = 0.016).Conclusion.LDA treatment does not appear to improve pregnancy outcome in low-risk women not fulfilling the criteria for APS. Because antibody profile seems to influence pregnancy outcome, further studies of patients stratified according to their antibody profile are warranted.

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