Citation
Blue, Nathan R.; Mele, Lisa; Grobman, William A.; Bailit, Jennifer L.; Wapner, Ronald J.; Thorp, John M., Jr.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T. N.; & Saade, George R., et al. (2022). Predictive Performance of Newborn Small for Gestational Age by a U.S. Intrauterine versus Birth Weight-Derived Standard for Short-Term Neonatal Morbidity and Mortality. American Journal of Obstetrics & Gynecology, 4(3), 100599. PMCID: PMC9097811Abstract
OBJECTIVE: The use of birth weight standards to define small for gestational age (SGA) may fail to identify neonates affected by poor fetal growth since they include births associated with sub-optimal fetal growth. Our objective was to compare intrauterine versus birth weight-derived standards to define newborn SGA to predict neonatal morbidity and mortality.STUDY DESIGN: This was a secondary analysis of a multi-center observational study of 118,422 births. Liveborn singleton, non-anomalous newborns born at 23-41 weeks were included. Those with missing gestational age estimation or without a 1(st) or 2(nd) trimester ultrasound to confirm dating, birth weight, or neonatal outcome data were excluded. Birth weight percentile was computed using an intrauterine standard (Hadlock, Radiology 1991) and a birth weight-derived standard (Olsen, Pediatrics 2010). We compared the test characteristics of SGA (birth weight <10(th) percentile) by each standard to predict a composite neonatal morbidity and mortality outcome (death prior to discharge, NICU admission >48 hours, respiratory distress syndrome, sepsis, necrotizing enterocolitis, grade III or IV intraventricular hemorrhage, or seizures). Severe composite morbidity was analyzed as a secondary outcome and was defined as death, NICU admission >7 days, NEC, grade 3-4 IVH, or seizures. The areas under the curve (AUC) using receiver-operating characteristic methodology and proportions of the primary outcome by SGA status were compared by gestational age category at birth (<34, 34(0)-36(6),
URL
http://dx.doi.org/10.1016/j.ajogmf.2022.100599Reference Type
Journal ArticleYear Published
2022Journal Title
American Journal of Obstetrics & GynecologyAuthor(s)
Blue, Nathan R.Mele, Lisa
Grobman, William A.
Bailit, Jennifer L.
Wapner, Ronald J.
Thorp, John M., Jr.
Caritis, Steve N.
Prasad, Mona
Tita, Alan T. N.
Saade, George R.
Rouse, Dwight J.
Blackwell, Sean C., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network