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Rodríguez Pulido F, Caballero Estebaranz N, García Caballero AA, González Dávila E, León Palacín C, Hernández Álvarez de Sotomayor MDC, López Reig S, Vílchez de León PI. Social cognition and emotional rehabilitation in participants with schizofrenia. Front Psychiatry 2023; 14:1250933. [PMID: 38025483 PMCID: PMC10663374 DOI: 10.3389/fpsyt.2023.1250933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction People with schizophrenia have deficits in social cognition, emotion and social perception, as well as attributional style. The purpose of this study was to evaluate the efficacy of a multicomponent social cognition training program, e-Motional Training® (ET), in people with schizophrenia and to compare its efficacy with people who did not receive it. Therefore, a single-blind RCT was conducted in participants with a diagnosis of schizophrenia. Methods A randomized, single-blind, clinical trial was conducted with 50 stable outparticipants with schizophrenia (registry number CHUC_2019_109). All participants (control and intervention) were treated with pharmacotherapy, case management and were on Individual Placement and Support methodology for competitive employment. The intervention group was treated with ET, an online program designed for social cognition rehabilitation. Pre and post assessment was performed using different battery of tests. General mixed models with subject identification and repeated measures over time were used. Results Different pre and post measurements were performed in the two groups. No significant differences were found in sociodemographic characteristics between the control and intervention groups. Improvements were obtained in the intervention group in the Ekman test (p = 0.009), mainly enhanced by the improvement shown in three emotions: fear, sadness and disgust (p = 0.041, p = 0.021 and p = 0.038 respectively). Conclusion ET is a promising online training tool for social cognition deficits in schizophrenia, in particular, for the improvement of emotions.Clinical Trial Registration: https://beta.clinicaltrials.gov, NCT05866328.
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Affiliation(s)
- Francisco Rodríguez Pulido
- Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - Nayra Caballero Estebaranz
- Department of Health Sciences, European University of the Canary Islands, La Orotava, Spain
- IPS Team Sinpromi, Cabildo de Tenerife, Santa Cruz de Tenerife, Spain
| | | | - Enrique González Dávila
- Department of Mathematics, Statistics and Operations Research Department, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - Celia León Palacín
- Canary Islands Association of Creative Therapies (ASCATEC), Santa Cruz de Tenerife, Spain
| | | | - Susana López Reig
- IPS Team Sinpromi, Cabildo de Tenerife, Santa Cruz de Tenerife, Spain
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Cabrera López C, Sánchez Santos A, Lemes Castellano A, Cazorla Rivero S, Breña Atienza J, González Dávila E, Celli B, Casanova Macario C. Eosinophil Subtypes in Adults with Asthma and Adults with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2023; 208:155-162. [PMID: 37071848 DOI: 10.1164/rccm.202301-0149oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/18/2023] [Indexed: 04/20/2023] Open
Abstract
Rationale: There is a differential response to eosinophilic modulation between patients with asthma and those with chronic obstructive pulmonary disease (COPD). There is also evidence of different subtypes of eosinophils in murine models. However, no study has compared eosinophil subtypes in individuals with COPD and in those with asthma. Objectives: Study the differences in eosinophils subtypes based in the surface protein expression in COPD patients and asthmatic patients. Methods: We studied 10 stable subjects in each of four groups: subjects with COPD, subjects with asthma, smokers without COPD, and healthy volunteers. Subjects with COPD and those with asthma were matched by age, sex, and FEV1% predicted. The following variables were determined: anthropometrics, smoking, exacerbation history, medication use, lung function, and comorbidities. Using flow cytometry and confocal microscopy from blood samples, we determined differences in eosinophil surface proteins and classified them as 1) resident eosinophils (Siglec-8+CD62L+IL-3Rlo) or 2) inflammatory eosinophils (iEos; Siglec-8+CD62LloIL-3Rhi). IL-5 receptor was also determined. Findings were validated in 59 patients with COPD and in 17 patients with asthma. Measurements and Main Results: Patients with asthma had a higher proportion of iEos (25 ± 15%) compared with those with COPD (0.5 ± 1%), smokers without COPD (0.14 ± 0.24%), and healthy volunteers (0.67 ± 1.72%). In patients with asthma, the proportion of iEos was independent of total eosinophil number. iEos had more IL-5 receptors than resident eosinophils (777.02 ± 124.55 vs. 598.35 ± 318.69; P < 0.01). In patients with COPD, there was no relation between iEos number and inhaled corticosteroid use, disease severity, or exacerbations rate. The findings in patients with COPD and those with asthma were confirmed in validation cohorts. Conclusions: There are differences in the subtypes of circulating eosinophils between patients with asthma and those with COPD. This could have clinical implications in the interpretation of eosinophil significance and the approach to therapy in these patients.
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Affiliation(s)
| | | | - Angelina Lemes Castellano
- Hematology Service, University Hospital of Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Sara Cazorla Rivero
- Research Unit, and
- Research Unit, La Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Joaquín Breña Atienza
- Hematology Service, La Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Enrique González Dávila
- Mathemathics, Statistics and Operations Research Department, IMAULL Institute, La Laguna University, San Cristóbal de La Laguna, Spain
| | - Bartolomé Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts; and
| | - Ciro Casanova Macario
- Pulmonary Department, Research Unit, La Candelaria University Hospital, La Laguna University, Carlos III Health Institute Biomedical Research Center, San Cristóbal de La Laguna, Spain
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González González NL, González Dávila E, González Martín A, Armas M, Tascón L, Farras A, Higueras T, Mendoza M, Carreras E, Goya M. Abnormal Maternal Body Mass Index and Customized Fetal Weight Charts: Improving the Identification of Small for Gestational Age Fetuses and Newborns. Nutrients 2023; 15:nu15030587. [PMID: 36771294 PMCID: PMC9920601 DOI: 10.3390/nu15030587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Obesity and thinness are serious diseases, but cases with abnormal maternal weight have not been excluded from the calculations in the construction of customized fetal growth curves (CCs). METHOD To determine if the new CCs, built excluding mothers with an abnormal weight, are better than standard CCs at identifying SGA. A total of 16,122 neonates were identified as SGA, LGA, or AGA, using the two models. Logistic regression and analysis of covariance were used to calculate the OR and CI for adverse outcomes by group. Gestational age was considered as a covariable. RESULTS The SGA rates by the new CCs and by the standard CCs were 11.8% and 9.7%, respectively. The SGA rate only by the new CCs was 18% and the SGA rate only by the standard CCs was 0.01%. Compared to AGA by both models, SGA by the new CCs had increased rates of cesarean section, (OR 1.53 (95% CI 1.19, 1.96)), prematurity (OR 2.84 (95% CI 2.09, 3.85)), NICU admission (OR 5.41 (95% CI 3.47, 8.43), and adverse outcomes (OR 1.76 (95% CI 1.06, 2.60). The strength of these associations decreased with gestational age. CONCLUSION The use of the new CCs allowed for a more accurate identification of SGA at risk of adverse perinatal outcomes as compared to the standard CCs.
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Affiliation(s)
- Nieves Luisa González González
- Department of Obstetrics and Gynecology, University of La Laguna, Hospital Universitario de Canarias, 38200 Tenerife, Spain
- Correspondence: ; Tel.: +34-922678335
| | - Enrique González Dávila
- Department of Mathematics, Statistics and Operations Research, IMAULL, University of La Laguna, 38200 Tenerife, Spain
| | - Agustina González Martín
- Department of Obstetrics and Gynecology, Hospital Universitario Ntra Sra de Candenlaria, 38200 Tenerife, Spain
| | - Marina Armas
- Department of Pediatrics, Evangelisches Krakenhaus König Elisabeth Herzberge, 10365 Berlin, Germany
| | - Laura Tascón
- Department of Obstetrics and Gynecology, University of La Laguna, Hospital Universitario de Canarias, 38200 Tenerife, Spain
| | - Alba Farras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Teresa Higueras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Manel Mendoza
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Elena Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - María Goya
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autónoma de Barcelona, Pg. de la Vall d'Hebron, 119, 08035 Barcelona, Spain
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González González NL, González Dávila E, González Martín A, Padrón E, García Hernández JÁ. Maternal Thinness and Obesity and Customized Fetal Weight Charts. Fetal Diagn Ther 2021; 48:551-559. [PMID: 34407539 DOI: 10.1159/000515251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 02/15/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to determine if customized fetal growth charts developed excluding obese and underweight mothers (CC(18.5-25)) are better than customized curves (CC) at identifying pregnancies at risk of perinatal morbidity. MATERIAL AND METHODS Data from 20,331 infants were used to construct CC and from 11,604 for CC(18.5-25), after excluding the cases with abnormal maternal BMI. The 2 models were applied to 27,507 newborns and the perinatal outcomes were compared between large for gestational age (LGA) or small for gestational age (SGA) according to each model. Logistic regression was used to calculate the OR of outcomes by the group, with gestational age (GA) as covariable. The confidence intervals of pH were calculated by analysis of covariance. RESULTS The rate of cesarean and cephalopelvic disproportion (CPD) were higher in LGAonly by CC(18.5-25) than in LGAonly by CC. In SGAonly by CC(18.5-25), neonatal intensive care unit (NICU) and perinatal mortality rates were higher than in SGAonly by CC. Adverse outcomes rate was higher in LGAonly by CC(18.5-25) than in LGAonly by CC (21.6%; OR = 1.61, [1.34-193]) vs. (13.5%; OR = 0.84, [0.66-1.07]), and in SGA only by CC(18.5-25) than in SGAonly by CC (9.6%; OR = 1.62, [1.25-2.10] vs. 6.3%; OR = 1.18, [0.85-1.66]). CONCLUSION The use of CC(18.5-25) allows a more accurate identification of LGA and SGA infants at risk of perinatal morbidity than conventional CC. This benefit increase and decrease, respectively, with GA.
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Affiliation(s)
- Nieves L González González
- Obstetrics and Gynecology Department, University of La Laguna, Canary Islands, University Hospital of Canary Islands., La Laguna, Spain
| | - Enrique González Dávila
- Mathematics, Statistics and Operations Research Department, University of La Laguna, La Laguna, Spain
| | - Agustina González Martín
- Obstetrics and Gynecology Department, University of La Laguna, Canary Islands, University Hospital of Canary Islands., La Laguna, Spain
| | - Erika Padrón
- Obstetrics and Gynecology Department, University of La Laguna, Canary Islands, University Hospital of Canary Islands., La Laguna, Spain
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Rodríguez Pulido F, Caballero Estebaranz N, González Dávila E, Melián Cartaya MJ. Cognitive remediation to improve the vocational outcomes of people with severe mental illness. Neuropsychol Rehabil 2019; 31:293-315. [PMID: 31752647 DOI: 10.1080/09602011.2019.1692671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigates the effects of cognitive remediation (CR) training with Individual Placement and Support (IPS) in people suffering from severe mental illness in European population (Spanish). Sixty-five participants (83% with schizophrenia or bipolar disorder) were recruited from community mental health teams. Fifty-seven met the criteria and agreed to participate in the study. The conditions of cognitive rehabilitation were assigned randomly with support employment CR + IPS (n = 28) and IPS alone (n = 29). Two groups were followed at 8 and 12 months after the baseline. Participants in the CR + IPS group improved more than the IPS only group during the follow-up period in measures of cognitive functioning (significantly higher in executive functions, verbal learning and memory) and obtained higher employment percentages during the follow-up period, including people who got a job after 8 months (52.2% versus 29.2%, p = .023) and after 1 year (60.9% versus 37.5%, p = .025), as well as, in the weekly hours worked (37.2 versus 26.7 h, p = .023). Retention in the CR + IPS program was high (82.14%). The calculated global cognitive score showed that the evolution over time differed significantly between groups (p < .001).
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Affiliation(s)
- Francisco Rodríguez Pulido
- Department of Medicina Interna, Dermatología y Psiquiatría, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Nayra Caballero Estebaranz
- Psychologist, SInpromi (Sociedad Insular para la promoción de las personas con discapacidad), Santa Cruz de Tenerife, Spain
| | - Enrique González Dávila
- Department of Matemáticas, Estadística e Investigación Operativa, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Maria Jesús Melián Cartaya
- Psychologist, SInpromi (Sociedad Insular para la promoción de las personas con discapacidad), Santa Cruz de Tenerife, Spain
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González-González NL, González Dávila E, Padrón E, Armas Gonzalez M, Plasencia W. Value of Placental Volume and Vascular Flow Indices as Predictors of Early and Late Preeclampsia at First Trimester. Fetal Diagn Ther 2018; 44:256-263. [PMID: 29393218 DOI: 10.1159/000481433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 08/07/2017] [Indexed: 12/28/2022]
Abstract
INTRODUCTION We evaluated the utility of placental volume and three-dimensional (3D) vascular flow indices to predict early and late preeclampsia. MATERIAL AND METHODS In 1,004 pregnancies attending routine care, we recorded first-trimester screening program for aneuploidy (FTSA) parameter and measured uterine artery pulsatility index (uterine-a PI). Placental volume and vascular flow indices were obtained using 3D power Doppler and VOCAL techniques. RESULTS Placental volume was lower and uterine-a PI was higher in both early and late preeclampsia groups versus nonaffected pregnancies. The prediction rate of placental volume in late preeclampsia was higher than that of uterine-a PI (AUROC 0.707 vs. 0.581, p < 0.011). The inclusion of placental volume improved significantly the prediction rate of total and late preeclampsia in the models constructed with maternal characteristics, FTSA, and uterine-a PI (AUROC 0.745 vs. 0.818, p < 0.004, and 0.740 vs. 0.812, p < 0.012, respectively). The inclusion of vascular indices did not improve the predictive value of these models. DISCUSSION Placental volume was an independent predictor of total, early, and late preeclampsia and its inclusion in combined predictive models significantly improved prediction rates. Reduced placental volume observed at first trimester in women with early and late preeclampsia suggests that these entities are the clinical expression of a similar pathophysiological process.
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Affiliation(s)
- Nieves L González-González
- Departamento de Obstetricia y Ginecología, Hospital Universitario de Canarias, Universidad de La Laguna, La Laguna,
| | - Enrique González Dávila
- Departamento de Matemáticas, Estadística e Investigación Operativa, Universidad de La Laguna, La Laguna, Spain
| | - Erika Padrón
- Departamento de Obstetricia y Ginecología, Hospital Universitario de Canarias, Universidad de La Laguna, La Laguna, Spain
| | - Marina Armas Gonzalez
- Departamento de Obstetricia y Ginecología, Hospital Universitario de Canarias, Universidad de La Laguna, La Laguna, Spain
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González González NL, González Dávila E, Goya M, Vega B, Hernández Suarez M, Bartha JL. Twin pregnancy among women with pregestational type 1 or type 2 diabetes mellitus. Int J Gynaecol Obstet 2014; 126:83-7. [PMID: 24797150 DOI: 10.1016/j.ijgo.2014.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 01/17/2014] [Accepted: 03/28/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the impact of twin versus singleton pregnancy on obstetric and perinatal outcomes among women with pregestational diabetes mellitus (DM). METHODS Multicenter retrospective cohort study of women with pregestational DM and twin or singleton pregnancy, conducted in Spain during 2005-2010. Each group included 63 women (type 1 DM, n=39; type 2 DM, n=24). RESULTS Of 269 565 deliveries, 68 (0.025%) were twins of mothers with pregestational DM, with 28/63 (44.4%) conceptions achieved with assisted reproduction technology. Among women with type 1 DM, hypertensive complications were more common among those with twins than among controls (13% versus 3%, P=0.02); the rate of preterm birth was higher (69% versus 15%, P<0.001); and the rate of admission to the neonatal intensive care unit was higher (51% versus 21%, P=0.005). Twin pregnancy was an independent risk factor for adverse perinatal outcomes regardless of the type of diabetes. CONCLUSION Twin pregnancy in women with either type of DM dramatically increased the risk of perinatal morbidity. In mothers with type 1 DM, twin pregnancy was more often associated with hypertensive complications than singleton pregnancy. Transfer of more than one embryo should be avoided if ART is needed in a woman with DM.
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Affiliation(s)
| | | | - Maria Goya
- Departamento de Obstetricia y Ginecología, Hospital Vall'de Hebrón, Barcelona, Spain
| | - Begoña Vega
- Departamento de Obstetricia y Ginecología, Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | | | - Jose L Bartha
- Departamento de Obstetricia y Ginecología, Hospital Universitario La Paz, Madrid, Spain
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González González NL, González Dávila E, Cabrera F, Padrón E, Castro JR, García Hernández JA. Customized weight curves for Spanish fetuses and newborns. J Matern Fetal Neonatal Med 2013; 27:1495-9. [PMID: 24168175 DOI: 10.3109/14767058.2013.860962] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To construct a model of customized birthweight curves for use in a Spanish population. MATERIALS AND METHODS Data of 20 331 newborns were used to construct a customized birthweight model. Multiple regression analysis was performed with newborn weight as the dependent variable and gestational age (GA), sex and maternal (M) weight, height, parity and ethnic origin as the independent variables. Using the new model, 27,507 newborns were classified as adequate for GA (AGA), large for GA (LGA) or small for GA (SGA). The results were compared with those of other customized and non-customized models. RESULTS The resulting formula for the calculation of optimal neonatal weight was: Optimum weight (g) = 3289.681 + 135.413*GA40-14.063*GA40(2)-0.838*GA40(3) + 113.889 (if multiparous) + 165.560 (if origin = Asia) + 161.550 (South America) + 67.927 (rest of Europe) +109.265 (North Africa) + 9.392*Maternal-Height + 4.856*Maternal-Weight-0.098*Maternal-Weight(2) + 0.001*Maternal-Weight(3) + 67.188*Sex + GA40*(6.890*Sex + 9.032 (If multiparous) +0.006*Maternal-Height(3) + 0.260*Maternal-Weight) + GA40(2) (-0.378*Maternal-Height - 0.008*Maternal-Height(2)) + GA40(3) (-0.032*Maternal-Height). Weight percentiles were obtained from standard data using optimum weight variation coefficient. Agreement between our customized model and other Spanish models was "good" (κ = 0.717 and κ = 0.736; p < 0.001). CONCLUSIONS Our model is comparable to other Spanish models, but offers the advantage of being customized, updated and freely available on the web. The 30.6% of infants classified as SGA using our model would be considered as AGA following a non-customized model.
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González González NL, Plasencia W, González Dávila E, Padrón E, di Renzo GC, Bartha JL. First and second trimester screening for large for gestational age infants. J Matern Fetal Neonatal Med 2013; 26:1635-40. [DOI: 10.3109/14767058.2013.794779] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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González González NL, Plasencia W, González Dávila E, Padrón E, García Hernández JA, Di Renzo GC, Bartha JL. The effect of customized growth charts on the identification of large for gestational age newborns. J Matern Fetal Neonatal Med 2012; 26:62-5. [PMID: 23043627 DOI: 10.3109/14767058.2012.726298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the effect of using customized vs. standard population birthweight curves to define large for gestational age (LGA) infants. METHODS We analyzed data obtained from 2,097 singleton pregnancies using three different methods of classifying newborn birthweight: standard population curves, British or Spanish customized curves. We recorded maternal characteristics, proportion of LGA newborns when using each method, percentage of LGA according to one method but not for the others, and concordance between the different methods. RESULTS The proportion of LGA newborns according to Spanish customized curves was significantly lower than that calculated using either standard general population birthweight curves or British curves (p < 0.001). A third (33.9%) of the infants classified as LGA according to the general population method were adequate for gestational age (AGA) when the Spanish customized curves were used, and 18.5% of non-LGA were LGA according to customized curves (p < 0.001). Concordance between the different models high, but on excluding AGA the concordance coefficient was low (Cohen's κ <0.4). CONCLUSIONS The use of customized curves allows differentiation between constitutional LGA and cases of fetal overgrowth, leading to a decrease in the rate of both false-positives and negatives as well as the overall proportion of LGA babies.
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