The efficiency evaluation of using the international anthropometric standards Intergrowth-21st and WHO Anthro in large for gestational age newborns from mothers with diabetes mellitus

Abstract

Objectives. To evaluate the effectiveness of using the international anthropometric standards Intergrowth-21st and WHO Anthro in large for gestational age infants born to mothers with type 1 diabetes mellitus (DM1). Material and methods. 129 full-term children (52 girls, 77 boys) born to mothers with DM1 were examined. Groups of newborns were identified taking into account gender, percentiles and z-scores of body weight, calculated using the Intergrowth-21st and WHO Anthro calculators. Results. Birth weight percentile was 96.0 (81.4-99.5) using Intergrowth-21st standards and 84.0 (58.7-94.1) using WHO Anthro (U=4824.0; p<0.001). The proportion of children classified as large for gestational age (more than the 90th percentile) was 64.3% and 35.7%, respectively (χ2=21.2, p<0.001). The proportion of overweight children according to +2 z-score (SDS) of birth weight was 39.5% using Intergrowth-21st and 17.8% using the WHO Anthro program (χ2=14.86, p<0.001). In the groups of newborns from mothers with DM1, classified according to WHO Anthro, the proportion of overweight children transferred from the maternity hospital to the inpatient department (p=0.010) and requiring medical care in the neonatal intensive care unit (p=0.005) was higher. Large for gestational age condition, defined according to Intergrowth-21st percentiles, is associated with early (p=0.005) and late (p=0.037) neonatal hypoglycemia, the likelihood of hospitalization in the neonatal intensive care unit (p=0.047), and a combined perinatal outcome in the form of diseases and conditions requiring transfer to a hospital for further treatment (p=0.010). Conclusions. When evaluating the effectiveness of the anthropometric standards Intergrowth-21st and WHO Anthro, significant differences were found in the detection and classification of large newborns from mothers with DM. Anthropometric indicators of large for gestational age children from mothers with DM are not strong predictors of a complicated course of adaptation, regardless of the international standard used.

Keywords

• newborn
• large for gestational age
• intergrowth-21st
• who anthro
• diagnosis
• pregnancy
• diabetes mellitus