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2022-02-19

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cc by (c) Fernández Alba, Juan Jesús et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/186717

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

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Recurs relacionat

https://doi.org/10.1186/s12884-022-04450-3

Resum

Background: Hypertensive 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. Objective: The 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. Method: A 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. Results: The 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)). Conclusion: In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st.

Matèries

Hipertensió en l'embaràs, Complicacions en l'embaràs, Assaigs clínics

Matèries (anglès)

Hypertension in pregnancy, Complications of pregnancy, Clinical trials

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Col·leccions

Articles publicats en revistes (BCNatal Fetal Medicine Research Center)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

FERNÁNDEZ ALBA, Juan jesús, CASTILLO LARA, Maria, SÁNCHEZ MERA, Raquel, ARAGÓN BAIZÁN, Sara, GONZÁLEZ MACÍAS, Carmen, QUINTERO PRADO, Rocío, VILAR SÁNCHEZ, Angel, JIMENEZ HERAS, Jose manuel, MORENO CORRAL, Luis javier, FIGUERAS RETUERTA, Francesc. INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy. _BMC Pregnancy Childbirth_. 2022. Vol. 22, núm. 1, pàgs. 136. [consulta: 31 de gener de 2026]. ISSN: 1471-2393. [Disponible a: https://hdl.handle.net/2445/186717]

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