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Hypoglycemia and the full-term newborn: how well does birth weight for gestational age predict risk?
J Obstet Gynecol Neonatal Nurs 2003 Jan-Feb; 32(1):48-57JO

Abstract

OBJECTIVE

To determine whether anthropometric characteristics could be used to accurately predict risk of hypoglycemia in full-term newborns during the early post-birth period.

DESIGN

Descriptive, utilizing newborn anthropometric measurements singly and in combination to determine risk of neonatal hypoglycemia. The following measurements were obtained twice for each newborn: weight, head circumference, chest circumference, abdominal circumference, mid-arm circumference, thigh circumference, and length. The investigator was blind to all measurements except weight.

SETTING

Mothers' rooms or the newborn nursery in a community hospital.

INTERVENTIONS

All measurements were obtained twice, and a physical examination was completed on each newborn by the principal investigator. These newborns were classified as large-, average-, and small-for-gestational age, using a tool typically used in many newborn nurseries.

SAMPLE

One hundred fifty-seven full-term newborns (94 White and 63 African American).

MAIN OUTCOME MEASURES

The differences in anthropometric measurements by race and gender were calculated using two-way analysis of variance. The risk of hypoglycemia was calculated using logistic regression modeling.

RESULTS

There were significant differences in measurements by race and by gender. Additionally, there was a subset of newborns classified as average for gestational age who had an increased risk of hypoglycemia (OR = 4.17, 95% CI = 1.33-13.08). Newborns with a mid-arm circumference/head circumference ratio that varied from .26 to .29 have an odds ratio of 6.10 (95% CI = 1.89-19.66) for risk of hypoglycemia. Plotting a newborn's birth weight on a published fetal growth curve clearly did not accurately predict his or her risk of hypoglycemia.

CONCLUSIONS

These findings indicate that extremes in newborn birth weight are not always correctly defined, may vary by race and ethnic group, and may not be the best method for determining under- or overnourishment and risk of neonatal hypoglycemia.

Authors+Show Affiliations

School of Nursing, University of Wisconsin-Milwaukee, 53201, USA. tsj@uwm.edu

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12570181

Citation

Johnson, Teresa S.. "Hypoglycemia and the Full-term Newborn: How Well Does Birth Weight for Gestational Age Predict Risk?" Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, vol. 32, no. 1, 2003, pp. 48-57.
Johnson TS. Hypoglycemia and the full-term newborn: how well does birth weight for gestational age predict risk? J Obstet Gynecol Neonatal Nurs. 2003;32(1):48-57.
Johnson, T. S. (2003). Hypoglycemia and the full-term newborn: how well does birth weight for gestational age predict risk? Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, 32(1), pp. 48-57.
Johnson TS. Hypoglycemia and the Full-term Newborn: How Well Does Birth Weight for Gestational Age Predict Risk. J Obstet Gynecol Neonatal Nurs. 2003;32(1):48-57. PubMed PMID: 12570181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypoglycemia and the full-term newborn: how well does birth weight for gestational age predict risk? A1 - Johnson,Teresa S, PY - 2003/2/7/pubmed PY - 2003/3/4/medline PY - 2003/2/7/entrez SP - 48 EP - 57 JF - Journal of obstetric, gynecologic, and neonatal nursing : JOGNN JO - J Obstet Gynecol Neonatal Nurs VL - 32 IS - 1 N2 - OBJECTIVE: To determine whether anthropometric characteristics could be used to accurately predict risk of hypoglycemia in full-term newborns during the early post-birth period. DESIGN: Descriptive, utilizing newborn anthropometric measurements singly and in combination to determine risk of neonatal hypoglycemia. The following measurements were obtained twice for each newborn: weight, head circumference, chest circumference, abdominal circumference, mid-arm circumference, thigh circumference, and length. The investigator was blind to all measurements except weight. SETTING: Mothers' rooms or the newborn nursery in a community hospital. INTERVENTIONS: All measurements were obtained twice, and a physical examination was completed on each newborn by the principal investigator. These newborns were classified as large-, average-, and small-for-gestational age, using a tool typically used in many newborn nurseries. SAMPLE: One hundred fifty-seven full-term newborns (94 White and 63 African American). MAIN OUTCOME MEASURES: The differences in anthropometric measurements by race and gender were calculated using two-way analysis of variance. The risk of hypoglycemia was calculated using logistic regression modeling. RESULTS: There were significant differences in measurements by race and by gender. Additionally, there was a subset of newborns classified as average for gestational age who had an increased risk of hypoglycemia (OR = 4.17, 95% CI = 1.33-13.08). Newborns with a mid-arm circumference/head circumference ratio that varied from .26 to .29 have an odds ratio of 6.10 (95% CI = 1.89-19.66) for risk of hypoglycemia. Plotting a newborn's birth weight on a published fetal growth curve clearly did not accurately predict his or her risk of hypoglycemia. CONCLUSIONS: These findings indicate that extremes in newborn birth weight are not always correctly defined, may vary by race and ethnic group, and may not be the best method for determining under- or overnourishment and risk of neonatal hypoglycemia. SN - 0884-2175 UR - https://www.unboundmedicine.com/medline/citation/12570181/Hypoglycemia_and_the_full_term_newborn:_how_well_does_birth_weight_for_gestational_age_predict_risk L2 - https://linkinghub.elsevier.com/retrieve/pii/S0884-2175(15)34046-6 DB - PRIME DP - Unbound Medicine ER -