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INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy
- Source :
- Dipòsit Digital de la UB, Universidad de Barcelona
- Publication Year :
- 2022
- Publisher :
- Springer Science and Business Media LLC, 2022.
-
Abstract
- 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 th centile or a ponderal index th 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 th 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 (th 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.
- Subjects :
- Nutritional Status
Gestational hypertension
Sensitivity and Specificity
Foetal malnutrition
Fetal Development
Hypertension in pregnancy
Clinical trials
Predictive Value of Tests
Pregnancy
Reference Values
Foetal growth
Odds Ratio
Birth Weight
Humans
Hipertensió en l'embaràs
reproductive and urinary physiology
Infant, Newborn
Obstetrics and Gynecology
Hypertension, Pregnancy-Induced
Reference Standards
Complicacions en l'embaràs
Infant Nutrition Disorders
Hypertensive disorders of pregnancy
Small for gestational age (SGA)
Spain
Complications of pregnancy
Infant, Small for Gestational Age
Female
Assaigs clínics
Subjects
Details
- ISSN :
- 14712393
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- BMC Pregnancy and Childbirth
- Accession number :
- edsair.doi.dedup.....9d0f8d41c9568f77ba5d6b3ef41c106c