Can Birth Weight Standards Based on Healthy Populations Improve the Identification of Small-for-Gestational-Age Newborns at Risk of Adverse Neonatal Outcomes?

PEDIATRICS ◽  
2009 ◽  
Vol 123 (2) ◽  
pp. 723-730 ◽  
Author(s):  
C. Ferdynus ◽  
C. Quantin ◽  
M. Abrahamowicz ◽  
R. Platt ◽  
A. Burguet ◽  
...  
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcomes ◽  
Adverse Neonatal Outcomes

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

2018 ◽  
Vol 46 (9) ◽  
pp. 1048-1056 ◽  
Author(s):  
Joanna Yu ◽  
Christopher Flatley ◽  
Ristan M. Greer ◽  
Sailesh Kumar
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Predicted Probability ◽  
Exposure Variable ◽  
Adverse Neonatal Outcomes ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Age At Birth

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.

scholarly journals Perinatal Factors Associated with Infant Maltreatment

2008 ◽  
Vol 1 ◽  
pp. CMPed.S980 ◽  
Author(s):  
Takeo Fujiwara ◽  
Makiko Okuyama ◽  
Haley Tsui ◽  
Karestan C. Koenen
Keyword(s):  
At Risk ◽  
Chronic Disease ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Z Score ◽  
Increased Risk

Background The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW), preterm, or small for gestational age (SGA) are at an increased risk of being maltreated. Methods A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35) and controls (N = 29) were compared on mean birth weight, gestational age, and z-score of birth weight. Results SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3). LBW and preterm births were not associated with infant maltreatment. Conclusion Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment. Abbreviations SCAN, Suspected Child Abuse and Neglect; LBW, low birth weight; ZBW, z-score of birth weight adjusted for gestational age, sex, and parity; SGA, small for gestational age; SD, standard deviation; OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; IPV, intimate partner violence.

Antibiotic Timing in Previable Prelabor Rupture of Membranes Less Than 24 Weeks of Gestation

2020 ◽  
Author(s):  
Rubymel J. Knupp ◽  
Sarah Pederson ◽  
Christina Blanchard ◽  
Jeff Szychowski ◽  
Deepa Etikala ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Neonatal Outcomes ◽  
Maternal Outcomes ◽  
Antibiotic Administration ◽  
Neonatal Birth Weight ◽  
Significant Difference ◽  
Adverse Neonatal Outcomes

Objective This study aimed to compare neonatal and maternal outcomes between immediate and delayed prophylactic antibiotic administration after previable prelabor premature rupture of membranes (PROM) less than 24 weeks of gestation. Study Design Retrospective cohort study of singleton pregnancies with PROM between 160/7 and 236/7 weeks of gestational age conducted at a single tertiary care referral center between June 2011 and December 2015. Patients with multiple gestations, fetal anomalies, those who elected augmentation, or with a contradiction to expectant management, such as suspected intra-amniotic infection or stillbirth, were excluded from the study. We compared pregnancy characteristics, maternal complications, and neonatal outcomes between women who received a course of antibiotics within 24 hours of PROM and women who received antibiotics after 24 hours of PROM. The primary outcome was neonatal survival to hospital discharge. Secondary outcomes included gestational age at delivery, time from PROM to delivery, neonatal birth weight, days in the neonatal intensive care unit (NICU), composite adverse neonatal outcomes, and maternal morbidity. Results Ninety-four women met inclusion criteria, 57 (61%) received antibiotics within 24 hours of PROM and 37 (39%) received antibiotics 24 hours after PROM. Baseline maternal characteristics were similar in both groups. The mean gestational age at PROM was similar between groups at 20.8 ± 2.3 weeks in the immediate antibiotics group and 20.6 ± 2.1 weeks in the delayed antibiotics group (p = 0.48). Compared with delayed antibiotic administration, immediate antibiotic administration was not associated with a significant difference in latency time from PROM to delivery, rate of stillbirth, days in an ICU, or adverse neonatal outcomes. Maternal outcomes also did not differ significantly between groups. Neonatal birth weight was lower in the immediate antibiotics group (p = 0.012). Conclusion Our data suggest that there is no maternal or neonatal benefit to immediate administration of latency antibiotics compared with delayed administration. Key Points

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