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Perinatal mortality by birthweight centile.
Aust N Z J Obstet Gynaecol. 2014 Aug; 54(4):354-9.AN

Abstract

BACKGROUND

Detection of abnormal fetal growth is vital to antenatal care, and traditionally birthweights that are <10th or >90th centile are classified as small or large for gestational age (LGA). Evidence regarding outcomes for birthweight centiles outside these extremes remains unclear.

AIMS

To evaluate the relationship between birthweight centile and perinatal death and determine the 'optimum' birthweight centile with the lowest rate of perinatal mortality.

METHOD

Data on all Victorian births from 1999 to 2008 were stratified into smaller subsets than the traditional small for gestational age (SGA) (<10th centile), appropriate for gestational age (AGA) (10-90th centile) and LGA (>90th centile) and analysed by all gestations, for term births alone, and using the 'fetus at risk' approach. Multiple logistic regression was used to adjust for age, parity and co-morbidities.

RESULTS

For term births, the 'optimum' birthweight centile was the 50-90th range (1.1 perinatal deaths/1000 births). Lower birthweight centiles had significantly higher rates of perinatal death - even those that would be classified as AGA. Babies with a 10-25th birthweight centile had a two-fold increased risk of perinatal death (AOR 2.10, 95% CI 1.6, 2.7). Even those with a 25-50th birthweight centile had higher perinatal mortality rates (AOR 1.58, 95% CI 1.3, 2.0). There was no strong evidence of higher perinatal mortality in larger birthweight centiles, except term births >99th centile. The 'fetus at risk' analysis showed a rise in perinatal mortality after 37 weeks' gestation for all birthweight centiles, particularly for SGA babies.

CONCLUSION

Babies with a birthweight below the 50th centile are at greater risk of perinatal mortality compared with the 'optimum' ≥50 to <90th centile group.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Francis JH
Mercy Hospital for Women, Heidleberg, Victoria, Australia.
Permezel M
No affiliation info available
Davey MA
No affiliation info available

MeSH

Birth WeightGestational AgeHumansInfantInfant MortalityInfant, NewbornInfant, Small for Gestational AgePerinatal MortalityRisk AssessmentStillbirthTerm BirthVictoria

Pub Type(s)

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

Language

eng

PubMed ID

24731210

Citation

Francis, Julia H., et al. "Perinatal Mortality By Birthweight Centile." The Australian & New Zealand Journal of Obstetrics & Gynaecology, vol. 54, no. 4, 2014, pp. 354-9.
Francis JH, Permezel M, Davey MA. Perinatal mortality by birthweight centile. Aust N Z J Obstet Gynaecol. 2014;54(4):354-9.
Francis, J. H., Permezel, M., & Davey, M. A. (2014). Perinatal mortality by birthweight centile. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 54(4), 354-9. https://doi.org/10.1111/ajo.12205
Francis JH, Permezel M, Davey MA. Perinatal Mortality By Birthweight Centile. Aust N Z J Obstet Gynaecol. 2014;54(4):354-9. PubMed PMID: 24731210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perinatal mortality by birthweight centile. AU - Francis,Julia H, AU - Permezel,Michael, AU - Davey,Mary Ann, Y1 - 2014/04/15/ PY - 2013/06/12/received PY - 2014/03/03/accepted PY - 2014/4/16/entrez PY - 2014/4/16/pubmed PY - 2015/5/13/medline KW - birthweight centile KW - large for gestational age KW - perinatal mortality KW - small for gestational age KW - stillbirth SP - 354 EP - 9 JF - The Australian & New Zealand journal of obstetrics & gynaecology JO - Aust N Z J Obstet Gynaecol VL - 54 IS - 4 N2 - BACKGROUND: Detection of abnormal fetal growth is vital to antenatal care, and traditionally birthweights that are <10th or >90th centile are classified as small or large for gestational age (LGA). Evidence regarding outcomes for birthweight centiles outside these extremes remains unclear. AIMS: To evaluate the relationship between birthweight centile and perinatal death and determine the 'optimum' birthweight centile with the lowest rate of perinatal mortality. METHOD: Data on all Victorian births from 1999 to 2008 were stratified into smaller subsets than the traditional small for gestational age (SGA) (<10th centile), appropriate for gestational age (AGA) (10-90th centile) and LGA (>90th centile) and analysed by all gestations, for term births alone, and using the 'fetus at risk' approach. Multiple logistic regression was used to adjust for age, parity and co-morbidities. RESULTS: For term births, the 'optimum' birthweight centile was the 50-90th range (1.1 perinatal deaths/1000 births). Lower birthweight centiles had significantly higher rates of perinatal death - even those that would be classified as AGA. Babies with a 10-25th birthweight centile had a two-fold increased risk of perinatal death (AOR 2.10, 95% CI 1.6, 2.7). Even those with a 25-50th birthweight centile had higher perinatal mortality rates (AOR 1.58, 95% CI 1.3, 2.0). There was no strong evidence of higher perinatal mortality in larger birthweight centiles, except term births >99th centile. The 'fetus at risk' analysis showed a rise in perinatal mortality after 37 weeks' gestation for all birthweight centiles, particularly for SGA babies. CONCLUSION: Babies with a birthweight below the 50th centile are at greater risk of perinatal mortality compared with the 'optimum' ≥50 to <90th centile group. SN - 1479-828X UR - https://www.unboundmedicine.com/medline/citation/24731210/Perinatal_mortality_by_birthweight_centile_ DB - PRIME DP - Unbound Medicine ER -