To determine whether an individualized growth standard (IS) improves identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death

Caritis, Steve N

Grobman, William A

Hankins, Gary D.V

Iams, Jay D

Lai, Yinglei

Leveno, Kenneth J

Malone, Fergal D

Mercer, Brian M

National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network

O'Sullivan, Mary J

Ramin, Susan M

Rouse, Dwight J

Sorokin, Yoram

Spong, Catherine Y

Thorp, John M

Varner, Michael W

Wapner, Ronald J

American Journal of Obstetrics and Gynecology

PubMed

William A. Grobman

Yinglei Lai

Dwight J. Rouse

Catherine Y. Spong

Michael W. Varner

Brian M. Mercer

Kenneth J. Leveno

Jay D. Iams

Ronald J. Wapner

Yoram Sorokin

John M. Thorp

Susan M. Ramin

Fergal D. Malone

Mary J. O'Sullivan

Gary D.V. Hankins

Steve N. Caritis

Crossref

The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles

The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death.
This study was a secondary analysis of data from a randomized trial of MgSO4 for the prevention of CP or death among anticipated preterm births. Singleton nonanomalous liveborns delivered before 34 weeks' were classified as SGA (less than the 10th percentile for their gestational age) by a population standard (PS) or an IS (incorporating maternal age, height, weight, parity, race/ethnicity, and neonatal sex). The primary outcome was the prediction of moderate or severe CP or death by age 2 years.
Of 1588 eligible newborns, 143 (9.4%) experienced CP (n = 33) or death (n = 110). Forty-four (2.8%) were SGA by the PS and 364 (22.9%) by the IS. All PS-SGA newborns also were identified as IS-SGA. SGA newborns by either standard had a similarly increased risk of CP or death (PS: relative risk [RR], 2.4, 95% confidence interval [CI], 1.3–4.3 vs IS: RR, 1.8, 95% CI, 1.3–2.5, respectively). The similarity of RRs remained after stratification by the MgSO4 treatment group. The IS was more sensitive (36% vs 6%, P < .001) but less specific (78% vs 98%, P < .001) for CP or death. The receiver operating characteristic curve analysis revealed a statistically lower area under the curve for the PS, although the ability of either method to predict which neonates would subsequently develop CP or death was poor (PS: 0.55, 95% CI, 0.49–0.60 vs IS: 0.59, 95% CI, 0.54–0.64, P < .001).
An individualized SGA growth standard does not improve the association with, or prediction of, CP or death by age 2 years

The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles

Abstract

Similar works

Full text

Available Versions

Crossref

University of Miami: Scholarship Miami

Carolina Digital Repository