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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

GRANDI, Carlos; LUCHTENBERG, Guillermo  y  ROJAS, Elio. Neonatal birth weight curves to evaluate the small for gestational age newborn. Rev. chil. pediatr. [online]. 2005, vol.76, n.3, pp.322-323. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062005000300015.

Introduction: Growth standards derived from birth weight at different gestational ages (neonatal curves) probably underestimate the small for gestational age (<10th percentile) prevalence, when compared with ultrasonographically determined fetal growth standards. The aim of this observational study was to compare local neonatal standards with estimated fetal weight, using different models, at similar gestational ages. Population, material and methods: 55,706 singleton births between 25th and 42th gestational weeks, born at Hospital Materno-Infantil “Ramón Sardᔠin Buenos Aires between 1988 and 1999, were included (preterms -25th to 36th weeks-, n= 3,745). A fractional growth curve was designed, using Mongelli´s formula, showing the fetal weight at any gestational age, as a percentage of the final term weight. Percentage differences were calculated at the 10th and 50th percentile levels, between observed weight (neonatal curve) and estimated weight (fractional curve). These differences were then compared with the 95% confidence interval (estimated absolute median error). The fractional curve of Hospital Materno-Infantil “Ramón Sardᔠwas compared with a similar one from Nottingham (UK) and with the Hadlock’s fetal ultrasonographic standards. Results: Neonatal weights were significantly lower than those derived from the fractional curve, for the 10th as well as for the 50th percentile. At the 10th percentile level, weights from neonatal standards for the premature period were significantly lower than those estimated ultrasonographically, while the Sardá fractional curve was slightly above that of Nottingham. The percentage differences between neonatal and predicted weights were highly significant for the premature period, being consistently higher for the 10th percentile (p=0.009). Differences at 10th percentile systematically fell above the upper limit of the 95% confidence interval. Conclusions : At the 10th percentile level, neonatal derived fetal growth standards of the preterm period (27th -34th weeks) were significantly lower than the estimated fractional and the published ultrasound derived fetal growth curves, while the local fractional curve fell slightly above that of Nottingham

Palabras clave : preterm; intrauterine growth restriction; standard.

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