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"INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes"

dc.contributor.authorFernández Alba, Juan Jesús 
dc.contributor.authorSoto Pazos, Estefanía
dc.contributor.authorMoreno Cortés, Rocío
dc.contributor.authorVilar Sánchez, Angel 
dc.contributor.authorGonzález Macías, María del Carmen 
dc.contributor.authorCastillo Lara, María
dc.contributor.authorMoreno Corral, Luis Javier 
dc.contributor.authorSainz Bueno, José Antonio
dc.contributor.otherEnfermería y Fisioterapiaes_ES
dc.contributor.otherMaterno-Infantil y Radiologíaes_ES
dc.date.accessioned2020-04-03T10:57:22Z
dc.date.available2020-04-03T10:57:22Z
dc.date.issued2020-03
dc.identifier.issn1471-2393
dc.identifier.urihttp://hdl.handle.net/10498/22730
dc.description.abstractBackground Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results Two hundred thirty-one pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21stes_ES
dc.formatapplication/pdfes_ES
dc.language.isoenges_ES
dc.publisherBMCes_ES
dc.rightsAtribución 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectSmall for gestational age (INFANT SGA)es_ES
dc.subjectFetal macrosomiaes_ES
dc.subjectDiabetes; Gestational (gestational diabetes)es_ES
dc.subjectBirth weightes_ES
dc.subjectFetal growthes_ES
dc.subjectFetal malnutritiones_ES
dc.subjectInfant overnutritiones_ES
dc.title"INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes"es_ES
dc.typejournal articlees_ES
dc.rights.accessRightsopen accesses_ES
dc.identifier.doi10.1186/s12884-020-2845-y


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