INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy

BMC Pregnancy and Childbirth

Francesc Figueras¹  Raquel Sánchez Mera²  Carmen González Macías²  Sara Aragón Baizán²  Angel Vilar Sánchez²  Maria Castillo Lara²  Rocio Quintero Prado²  Juan Jesús Fernández-Alba³  Jose Manuel Jimenez Heras⁴  Luis Javier Moreno Corral⁵ 

[1] Barcelona Center for Maternal–Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain;Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain;Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain;Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA). Fundación Cádiz - Hospital Universitario Puerto del Mar, 9º planta. Avda. Ana de Viya, 21 - 11009, Cadiz, Spain;Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA). Fundación Cádiz - Hospital Universitario Puerto del Mar, 9º planta. Avda. Ana de Viya, 21 - 11009, Cadiz, Spain;Nursing Department, Faculty of Nursing and Physiotherapy, Cadiz University, Cadiz, Spain;

关键词: Foetal growth;    Foetal malnutrition;    Hypertensive disorders of pregnancy;    Gestational hypertension;    Small for gestational age (SGA);   

DOI  :  10.1186/s12884-022-04450-3

来源: Springer

【 摘 要 】

BackgroundHypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information.ObjectiveThe objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP.MethodA comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index < 10th centile or a ponderal index < 10th centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden’s index and probability ratios.ResultsThe study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p < 0.01). Using body mass index (< 10th centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86–12.77) vs. 3.75 (95% CI: 1.49–9.43)) (DOR: 5.56 (95% CI: 1.82–16.98) vs. 4.84 (95% CI: 1.51–15.54)) Even when using Ponderal index (< 10th centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11–5.05) vs. 1.68 (95% CI: 0.70–4.03))(DOR 2.62 (95% CI: 1.00–6.87) vs. 1.90 (95% CI: 0.61–5.92)).ConclusionIn pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st.

【 授权许可】

CC BY