Neonatal mortality risk of large-for-gestational-age and macrosomic live births in 15 countries, including 115.6 million nationwide linked records, 2000-2020
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd..
OBJECTIVE: We aimed to compare the prevalence and neonatal mortality associated with large for gestational age (LGA) and macrosomia among 115.6 million live births in 15 countries, between 2000 and 2020.
DESIGN: Population-based, multi-country study.
SETTING: National healthcare systems.
POPULATION: Liveborn infants.
METHODS: We used individual-level data identified for the Vulnerable Newborn Measurement Collaboration. We calculated the prevalence and relative risk (RR) of neonatal mortality among live births born at term + LGA (>90th centile, and also >95th and >97th centiles when the data were available) versus term + appropriate for gestational age (AGA, 10th-90th centiles) and macrosomic (≥4000, ≥4500 and ≥5000 g, regardless of gestational age) versus 2500-3999 g. INTERGROWTH 21st served as the reference population.
MAIN OUTCOME MEASURES: Prevalence and neonatal mortality risks.
RESULTS: Large for gestational age was common (median prevalence 18.2%; interquartile range, IQR, 13.5%-22.0%), and overall was associated with a lower neonatal mortality risk compared with AGA (RR 0.83, 95% CI 0.77-0.89). Around one in ten babies were ≥4000 g (median prevalence 9.6% (IQR 6.4%-13.3%), with 1.2% (IQR 0.7%-2.0%) ≥4500 g and with 0.2% (IQR 0.1%-0.2%) ≥5000 g). Overall, macrosomia of ≥4000 g was not associated with increased neonatal mortality risk (RR 0.80, 95% CI 0.69-0.94); however, a higher risk was observed for birthweights of ≥4500 g (RR 1.52, 95% CI 1.10-2.11) and ≥5000 g (RR 4.54, 95% CI 2.58-7.99), compared with birthweights of 2500-3999 g, with the highest risk observed in the first 7 days of life.
CONCLUSIONS: In this population, birthweight of ≥4500 g was the most useful marker for early mortality risk in big babies and could be used to guide clinical management decisions.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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Enthalten in: |
BJOG : an international journal of obstetrics and gynaecology - (2023) vom: 27. Nov. |
Sprache: |
Englisch |
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Links: |
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Themen: |
Fetal macrosomia |
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Anmerkungen: |
Date Revised 27.11.2023 published: Print-Electronic Citation Status Publisher |
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doi: |
10.1111/1471-0528.17706 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM365032980 |
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100 | 1 | |a Suárez-Idueta, Lorena |e verfasserin |4 aut | |
245 | 1 | 0 | |a Neonatal mortality risk of large-for-gestational-age and macrosomic live births in 15 countries, including 115.6 million nationwide linked records, 2000-2020 |
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500 | |a Date Revised 27.11.2023 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status Publisher | ||
520 | |a © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. | ||
520 | |a OBJECTIVE: We aimed to compare the prevalence and neonatal mortality associated with large for gestational age (LGA) and macrosomia among 115.6 million live births in 15 countries, between 2000 and 2020 | ||
520 | |a DESIGN: Population-based, multi-country study | ||
520 | |a SETTING: National healthcare systems | ||
520 | |a POPULATION: Liveborn infants | ||
520 | |a METHODS: We used individual-level data identified for the Vulnerable Newborn Measurement Collaboration. We calculated the prevalence and relative risk (RR) of neonatal mortality among live births born at term + LGA (>90th centile, and also >95th and >97th centiles when the data were available) versus term + appropriate for gestational age (AGA, 10th-90th centiles) and macrosomic (≥4000, ≥4500 and ≥5000 g, regardless of gestational age) versus 2500-3999 g. INTERGROWTH 21st served as the reference population | ||
520 | |a MAIN OUTCOME MEASURES: Prevalence and neonatal mortality risks | ||
520 | |a RESULTS: Large for gestational age was common (median prevalence 18.2%; interquartile range, IQR, 13.5%-22.0%), and overall was associated with a lower neonatal mortality risk compared with AGA (RR 0.83, 95% CI 0.77-0.89). Around one in ten babies were ≥4000 g (median prevalence 9.6% (IQR 6.4%-13.3%), with 1.2% (IQR 0.7%-2.0%) ≥4500 g and with 0.2% (IQR 0.1%-0.2%) ≥5000 g). Overall, macrosomia of ≥4000 g was not associated with increased neonatal mortality risk (RR 0.80, 95% CI 0.69-0.94); however, a higher risk was observed for birthweights of ≥4500 g (RR 1.52, 95% CI 1.10-2.11) and ≥5000 g (RR 4.54, 95% CI 2.58-7.99), compared with birthweights of 2500-3999 g, with the highest risk observed in the first 7 days of life | ||
520 | |a CONCLUSIONS: In this population, birthweight of ≥4500 g was the most useful marker for early mortality risk in big babies and could be used to guide clinical management decisions | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a fetal macrosomia | |
650 | 4 | |a infant | |
650 | 4 | |a large for gestational age | |
650 | 4 | |a neonatal mortality | |
650 | 4 | |a pregnancy | |
700 | 1 | |a Ohuma, Eric O |e verfasserin |4 aut | |
700 | 1 | |a Chang, Chia-Jung |e verfasserin |4 aut | |
700 | 1 | |a Hazel, Elizabeth A |e verfasserin |4 aut | |
700 | 1 | |a Yargawa, Judith |e verfasserin |4 aut | |
700 | 1 | |a Okwaraji, Yemisrach B |e verfasserin |4 aut | |
700 | 1 | |a Bradley, Ellen |e verfasserin |4 aut | |
700 | 1 | |a Gordon, Adrienne |e verfasserin |4 aut | |
700 | 1 | |a Sexton, Jessica |e verfasserin |4 aut | |
700 | 1 | |a Lawford, Harriet L S |e verfasserin |4 aut | |
700 | 1 | |a Paixao, Enny S |e verfasserin |4 aut | |
700 | 1 | |a Falcão, Ila R |e verfasserin |4 aut | |
700 | 1 | |a Lisonkova, Sarka |e verfasserin |4 aut | |
700 | 1 | |a Wen, Qi |e verfasserin |4 aut | |
700 | 1 | |a Velebil, Petr |e verfasserin |4 aut | |
700 | 1 | |a Jírová, Jitka |e verfasserin |4 aut | |
700 | 1 | |a Horváth-Puhó, Erzsebet |e verfasserin |4 aut | |
700 | 1 | |a Sørensen, Henrik T |e verfasserin |4 aut | |
700 | 1 | |a Sakkeus, Luule |e verfasserin |4 aut | |
700 | 1 | |a Abuladze, Lili |e verfasserin |4 aut | |
700 | 1 | |a Yunis, Khalid A |e verfasserin |4 aut | |
700 | 1 | |a Al Bizri, Ayah |e verfasserin |4 aut | |
700 | 1 | |a Alvarez, Sonia Lopez |e verfasserin |4 aut | |
700 | 1 | |a Broeders, Lisa |e verfasserin |4 aut | |
700 | 1 | |a van Dijk, Aimée E |e verfasserin |4 aut | |
700 | 1 | |a Alyafei, Fawziya |e verfasserin |4 aut | |
700 | 1 | |a AlQubaisi, Mai |e verfasserin |4 aut | |
700 | 1 | |a Razaz, Neda |e verfasserin |4 aut | |
700 | 1 | |a Söderling, Jonas |e verfasserin |4 aut | |
700 | 1 | |a Smith, Lucy K |e verfasserin |4 aut | |
700 | 1 | |a Matthews, Ruth J |e verfasserin |4 aut | |
700 | 1 | |a Lowry, Estelle |e verfasserin |4 aut | |
700 | 1 | |a Rowland, Neil |e verfasserin |4 aut | |
700 | 1 | |a Wood, Rachael |e verfasserin |4 aut | |
700 | 1 | |a Monteath, Kirsten |e verfasserin |4 aut | |
700 | 1 | |a Pereyra, Isabel |e verfasserin |4 aut | |
700 | 1 | |a Pravia, Gabriella |e verfasserin |4 aut | |
700 | 1 | |a Lawn, Joy E |e verfasserin |4 aut | |
700 | 1 | |a Blencowe, Hannah |e verfasserin |4 aut | |
700 | 0 | |a National Vulnerable Newborn Mortality Collaborative Group and the Vulnerable Newborn Measurement Core Group |e verfasserin |4 aut | |
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700 | 1 | |a Warrilow, Kara |e investigator |4 oth | |
700 | 1 | |a Lawford, Harriet |e investigator |4 oth | |
700 | 1 | |a Barreto, Mauricio Lima |e investigator |4 oth | |
700 | 1 | |a Falcão, Ila Rocha |e investigator |4 oth | |
700 | 1 | |a Horváth-Puhó, Erzsébet |e investigator |4 oth | |
700 | 1 | |a Abuladze, Liili |e investigator |4 oth | |
700 | 1 | |a Nakad, Pascale |e investigator |4 oth | |
700 | 1 | |a Flores, Arturo Barranco |e investigator |4 oth | |
700 | 1 | |a Gonzalez Roldan, Jesus Felipe |e investigator |4 oth | |
700 | 1 | |a Alyafei, Fawzia |e investigator |4 oth | |
700 | 1 | |a Olukade, Tawa O |e investigator |4 oth | |
700 | 1 | |a Ali, Hamdy A |e investigator |4 oth | |
700 | 1 | |a Alturk, Mohamad Rami |e investigator |4 oth | |
700 | 1 | |a Manktelow, Bradley N |e investigator |4 oth | |
700 | 1 | |a Draper, Elizabeth |e investigator |4 oth | |
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700 | 1 | |a Davis, Celina |e investigator |4 oth | |
700 | 1 | |a Clarke, Samantha |e investigator |4 oth | |
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