Abstract

Background

Clinicians and researchers use a variety of intrauterine growth curves to classify NICU infants as small (SGA), appropriate (AGA), or large for gestational age (LGA). Since curve creation methods and samples vary, SGA/AGA/LGA cut-offs and resulting subgroups of infants vary among curves and impact outcome study findings - limiting generalisability.

Aim

Determine how two international and two US-specific curves classified US NICU infants.

Subjects and methods

Classified 192,888 infants from US NICUs (2013–2016) as SGA or LGA for birthweight, length, and head circumference, using the international Fenton and INTERGROWTH-21st curves and US-specific Olsen and Lubchenco (historical) curves.

Results

Modern curves classified approximately 10% of infants as SGA up to 32 weeks, but older infants had increased variability. The INTERGROWTH-21st curves consistently had rates above 10% for LGA after 32 weeks.

Conclusions

While Olsen and Fenton both fit, the Olsen curves had overall best-fit for our sample of US NICU infants. The INTERGROWTH-21st curves fit the definitions for SGA and LGA for younger ages, but inferences outside of these definitions are unwarranted due to limited sample size. The INTERGROWTH-21st sample used for 33 weeks and older infants was physically smaller at the upper percentiles than our sample of US infants.

中文翻译：

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通过美国和国际增长曲线对美国新生儿重症监护室中的婴儿的体重，身长和头围进行分类。

摘要

背景

临床医生和研究人员使用各种子宫内生长曲线将新生儿重症监护病房婴儿分为小（SGA），适当（AGA）或大于胎龄（LGA）。由于曲线的创建方法和样本不同，因此SGA / AGA / LGA的临界值以及由此产生的婴儿亚组在曲线之间也会有所不同，从而影响结果研究结果-限制了通用性。

目标

确定如何通过两条国际曲线和两条针对美国的曲线对US NICU婴儿进行分类。

主题与方法

使用国际Fenton和INTERGROWTH-21st曲线以及美国特定的Olsen和Lubchenco（历史）曲线，将192,888名来自美国重症监护病房（2013-2016年）的婴儿按出生体重，身长和头围分为SGA或LGA。

结果

现代曲线在32周内将约10％的婴儿归为SGA，但年龄较大的婴儿的变异性增加。INTERGROWTH-21st曲线在32周后LGA的发生率始终高于10％。

结论

虽然奥尔森（Olsen）和芬顿（Fenton）都拟合，但奥尔森曲线对我们的美国NICU婴儿样本总体上最拟合。INTERGROWTH-21st曲线适合较小年龄的SGA和LGA的定义，但是由于样本量有限，因此无法保证超出这些定义的推断。在33周及以上的婴儿中使用的INTERGROWTH-21st样本在较高百分位数处的体格比美国婴儿样本小。