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      Patrones de peso al nacer en Venezuela: influencia de la edad materna y la paridad

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          Abstract

          Objetivo: Validar varios patrones de peso al nacer, incluyendo aquellos derivados de estudios nacionales. Métodos: Estudio analítico, de corte transversal. La validación se basó en una muestra de 16434 neonatos (2000 - 2004), que se clasificaron por edad gestacional según cada patrón. Los análisis se basaron en la distribución percentilar (< 10°, 10 - 90°, >90°), comparando las frecuencias observadas y predichas por la prueba X². Ambiente: Universidad Centroccidental "Lisandro Alvarado" / Hospital Central Universitario "Antonio María Pineda" Resultados: Las clasificaciones fueron muy similares, aunque fueron ligeramente mejores para los patrones de Battaglia y Lubchenco. Hubo notables diferencias relacionadas son la edad y paridad maternas, cuantitativamente similares a las atribuibles al sexo del neonato. Conclusión: Parece recomendable seguir usando los patrones de Battaglia y Lubchenco para clasificar los neonatos, al menos hasta que un nuevo y mejor grupo nacional de patrones esté disponible.

          Translated abstract

          Objective: To validate several birth-weight-for-gestation-age charts, including those derived from national studies. Methods: Analytic, cross-sectional study. The validation was based on a sample of 16434 newborns (2000 - 2004), which were classified by gestational age and birth according to each chart. Analyses were based on the percentile distribution (< 10°, 10 - 90°, >90°), by comparing the observed and predicted frequencies by the X² test. Setting: Universidad Centroccidental "Lisandro Alvarado" / Hospital Central Universitario "Antonio María Pineda" Results: The resulting classifications were very similar, although the categorization seemed slightly better when using Battaglia and Lubchenco charts. There were notable differences related to maternal age and parity, quantitatively similar to those attributable to the gender of the newborn. Conclusion: It seems advisable to maintain the use of Battaglia and Lubchenco charts as the basis for classification of newborns, at least until a new and better set of national charts become available.

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          A new and improved population-based Canadian reference for birth weight for gestational age.

          Existing fetal growth references all suffer from 1 or more major methodologic problems, including errors in reported gestational age, biologically implausible birth weight for gestational age, insufficient sample sizes at low gestational age, single-hospital or other non-population-based samples, and inadequate statistical modeling techniques. We used the newly developed Canadian national linked file of singleton births and infant deaths for births between 1994 and 1996, for which gestational age is largely based on early ultrasound estimates. Assuming a normal distribution for birth weight at each gestational age, we used the expectation-maximization algorithm to exclude infants with gestational ages that were more consistent with 40-week births than with the observed gestational age. Distributions of birth weight at the corrected gestational ages were then statistically smoothed. The resulting male and female curves provide smooth and biologically plausible means, standard deviations, and percentile cutoffs for defining small- and large-for-gestational-age births. Large-for-gestational age cutoffs (90th percentile) at low gestational ages are considerably lower than those of existing references, whereas small-for-gestational-age cutoffs (10th percentile) postterm are higher. For example, compared with the current World Health Organization reference from California (Williams et al, 1982) and a recently proposed US national reference (Alexander et al, 1996), the 90th percentiles for singleton males at 30 weeks are 1837 versus 2159 and 2710 g. The corresponding 10th percentiles at 42 weeks are 3233 versus 3086 and 2998 g. This new sex-specific, population-based reference should improve clinical assessment of growth in individual newborns, population-based surveillance of geographic and temporal trends in birth weight for gestational age, and evaluation of clinical or public health interventions to enhance fetal growth. fetal growth, birth weight, gestational age, preterm birth, postterm birth.
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            A nearly continuous measure of birth weight for gestational age using a United States national reference

            Background Fully understanding the determinants and sequelae of fetal growth requires a continuous measure of birth weight adjusted for gestational age. Published United States reference data, however, provide estimates only of the median and lowest and highest 5th and 10th percentiles for birth weight at each gestational age. The purpose of our analysis was to create more continuous reference measures of birth weight for gestational age for use in epidemiologic analyses. Methods We used data from the most recent nationwide United States Natality datasets to generate multiple reference percentiles of birth weight at each completed week of gestation from 22 through 44 weeks. Gestational age was determined from last menstrual period. We analyzed data from 6,690,717 singleton infants with recorded birth weight and sex born to United States resident mothers in 1999 and 2000. Results Birth weight rose with greater gestational age, with increasing slopes during the third trimester and a leveling off beyond 40 weeks. Boys had higher birth weights than girls, later born children higher weights than firstborns, and infants born to non-Hispanic white mothers higher birth weights than those born to non-Hispanic black mothers. These results correspond well with previously published estimates reporting limited percentiles. Conclusions Our method provides comprehensive reference values of birth weight at 22 through 44 completed weeks of gestation, derived from broadly based nationwide data. Other approaches require assumptions of normality or of a functional relationship between gestational age and birth weight, which may not be appropriate. These data should prove useful for researchers investigating the predictors and outcomes of altered fetal growth.
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              Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                September 2009
                : 69
                : 3
                : 162-171
                Affiliations
                [1 ] Universidad Centroccidental Lisandro Alvarado Venezuela
                [2 ] Universidad Simón Bolívar Venezuela
                [3 ] Universidad Centroccidental Lisandro Alvarado Venezuela
                [4 ] Universidad Centroccidental Lisandro Alvarado Venezuela
                [5 ] Universidad Centroccidental Lisandro Alvarado Venezuela
                Article
                S0048-77322009000300004
                6aa1719f-d48c-47f5-be2f-f4bf873aa0cb

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Birth weight,Parity,Maternal age,Birth-weight-for-gestation-age charts,Peso al nacer,Paridad,Edad materna,Patrones de peso para la edad gestacional

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