RT journal article
T1 "INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes"
A1 Fernández Alba, Juan Jesús
A1 Soto Pazos, Estefanía
A1 Moreno Cortés, Rocío
A1 Vilar Sánchez, Angel
A1 González Macías, María del Carmen
A1 Castillo Lara, María
A1 Moreno Corral, Luis Javier
A1 Sainz Bueno, José Antonio
A2 Enfermería y Fisioterapia
A2 Materno-Infantil y Radiología
K1 Small for gestational age (INFANT SGA)
K1 Fetal macrosomia
K1 Diabetes; Gestational (gestational diabetes)
K1 Birth weight
K1 Fetal growth
K1 Fetal malnutrition
K1 Infant overnutrition
AB Background 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 INTERGROWTH21st
PB BMC
SN 1471-2393
YR 2020
FD 2020-03
LK http://hdl.handle.net/10498/22730
UL http://hdl.handle.net/10498/22730
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-may-2026