Nuevas curvas poblacionales de crecimiento en recién nacidos extremadamente prematuros españoles

Comparative analysis of foetal and neonatal growth curves

INTRODUCTION

Our aim was to determine which foetal or neonatal growth curves discriminate the probability of dying of newborns with low birth weight for their gestational age (small for gestational age, SGA) and sex (weight < 10th percentile) and to establish the curves that are presumably most useful for monitoring growth through age 10 years.

MATERIAL AND METHODS

The analysis included every neonate (15 122) managed in our hospital (2013-2022) and all neonates born preterm before 32 weeks (6913) registered in the SEN1500 database (2019-2022). We considered most useful those curves with the highest likelihood ratio (LR) for dying with or without a history of SGA in each subgroup of gestational ages. Theoretically, the optimal curves for monitoring growth would be those with a higher R2 in the quantile regression formulas for the 50th percentile.

RESULTS

The growth curves exhibiting the strongest association between SGA and hospital mortality are the Intergrowth fetal curves and the Fenton neonatal curves in infants born preterm before 32 weeks. However, the optimal curves for premature babies and neonates overall were those of Olsen and Intergrowth. The most useful curves to monitor anthropometric values alone until age 10 years of age are the longitudinal Intergrowth curves followed by the WHO standards, but if a single reference is desired from birth through age 10 years, the best option is the Fenton curves followed by the WHO standards.

CONCLUSIONS

The Intergrowth reference provides the most discriminating foetal growth curves. In neonatal clinical practice, the optimal references are the Fenton followed by the WHO charts.

New Growth Curves for Spanish Children (0-10 Years) in the Region of Extremadura

The anthropometric reference data used to examine the growth pattern of children in Spain are obtained from studies carried out several years ago. In the region of Extremadura, the tables obtained by the Faustino Obergozo Foundation, which date back to 2004, are used. The first objective of this work is to develop growth tables and graphs that accurately reflect the somatometric variables of children in Extremadura. Secondly, the averages of these variables by sex will be compared to determine if there are significant differences between them. A database provided by the General Directorate of Planning, Training, and Health and Social Quality of the Regional Government of Extremadura was used, which contains the measurements of height, weight, and body mass index (BMI) of boys and girls in Extremadura between the years 2006-2016. The database was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23 and the R software version 3.5.1, considering a cross-sectional study. As a result, the tables and growth graphs of Extremadura's population base for weight and height are presented, from birth to 10 years, as well as comparisons of the average values of the analyzed variables between boys and girls. We found that there are significant differences in the mean values, according to sex, of the height and weight. On the other hand, BMI progressed normally when comparing the results of the Extremadura population with those reflected by the World Health Organization (WHO). Differences were found when comparing the results with those obtained by the Faustino Orbegozo Foundation.

New birthweight charts according to parity and type of delivery for the Spanish population

OBJECTIVE

Birthweight by gestational age charts enable fetal growth to be evaluated in a specific population. Given that maternal profile and obstetric practice have undergone a remarkable change over the past few decades in Spain, this paper presents new Spanish reference percentile charts stratified by gender, parity and type of delivery. They have been prepared with data from the 2010-2014 period of the Spanish Birth Statistics Bulletin.

METHODS

Reference charts have been prepared using the LMS method, corresponding to 1,428,769 single, live births born to Spanish mothers. Percentile values and mean birth weight are compared among newborns according to gender, parity and type of delivery.

RESULTS

Newborns to primiparous mothers show significantly lower birthweight than those born to multiparous mothers (p<0.036). Caesarean section was associated with a substantially lower birthweight in preterm births (p<0.048), and with a substantially higher birthweight for full-term deliveries (p<0.030). Prevalence of small for gestational age is significantly higher in newborns born by Caesarean section, both in primiparous (p<0.08) and multiparous mothers (p<0.027) and, conversely, the prevalence of large for gestational age among full-term births is again greater both in primiparous (p<0.035) and in multiparous mothers (p<0.007).

CONCLUSIONS

Results support the consideration of establishing parity and type of delivery-specific birthweight references. These new charts enable a better evaluation of the impact of the demographic, reproductive and obstetric trends currently in Spain on fetal growth.