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Birth-weight centiles and the risk of serious adverse neonatal outcomes at term.
J Perinat Med. 2018 Nov 27; 46(9):1048-1056.JP

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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Publisher Full Text (DOI)

Authors+Show Affiliations

Yu J
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia. School of Medicine, The University of Queensland, Herston, Queensland, Australia.
Flatley C
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia.
Greer RM
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia.
Kumar S
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia. School of Medicine, The University of Queensland, Herston, Queensland, Australia.

MeSH

AustraliaBirth WeightFemaleGestational AgeHumansInfantInfant MortalityInfant, NewbornInfant, Small for Gestational AgeIntensive Care Units, NeonatalMalePregnancyPregnancy OutcomePrognosisRetrospective StudiesRisk AssessmentRisk FactorsTerm Birth

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29257760

Citation

Yu, Joanna, et al. "Birth-weight Centiles and the Risk of Serious Adverse Neonatal Outcomes at Term." Journal of Perinatal Medicine, vol. 46, no. 9, 2018, pp. 1048-1056.
Yu J, Flatley C, Greer RM, et al. Birth-weight centiles and the risk of serious adverse neonatal outcomes at term. J Perinat Med. 2018;46(9):1048-1056.
Yu, J., Flatley, C., Greer, R. M., & Kumar, S. (2018). Birth-weight centiles and the risk of serious adverse neonatal outcomes at term. Journal of Perinatal Medicine, 46(9), 1048-1056. https://doi.org/10.1515/jpm-2017-0176
Yu J, et al. Birth-weight Centiles and the Risk of Serious Adverse Neonatal Outcomes at Term. J Perinat Med. 2018 Nov 27;46(9):1048-1056. PubMed PMID: 29257760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Birth-weight centiles and the risk of serious adverse neonatal outcomes at term. AU - Yu,Joanna, AU - Flatley,Christopher, AU - Greer,Ristan M, AU - Kumar,Sailesh, PY - 2017/06/01/received PY - 2017/11/07/accepted PY - 2017/12/20/pubmed PY - 2019/3/13/medline PY - 2017/12/20/entrez KW - Birth-weight KW - gestational age KW - mode of birth KW - serious adverse neonatal outcomes SP - 1048 EP - 1056 JF - Journal of perinatal medicine JO - J Perinat Med VL - 46 IS - 9 N2 - 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. SN - 1619-3997 UR - https://www.unboundmedicine.com/medline/citation/29257760/Birth_weight_centiles_and_the_risk_of_serious_adverse_neonatal_outcomes_at_term_ DB - PRIME DP - Unbound Medicine ER -