Revista de la Facultad de Ciencias Médicas de Córdoba (May 2020)

Evaluation of the INTERGROWTH-21st project newborn standard for neonatal phenotypes and neonatal morbidity and mortality

  • Carlos Grandi,
  • Mariana del Pino,
  • Davi Casale Aragon,
  • Livia dos Santos Rodrigues,
  • Viviane Cunha Cardoso

DOI
https://doi.org/10.31053/1853.0605.v77.n2.28064
Journal volume & issue
Vol. 77, no. 2
pp. 86 – 93

Abstract

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Introduction The use of local references or standard for neonatal studies still requires their validation through indicators of morbidity and mortality. Objective: evaluate the performance of the INTERGROWTH-21st Project (IG-21) standard and a commonly used Argentinian reference (Urquia) by examining the differences in the frequency of growth phenotypes, and the associated neonatal morbidity and mortality. Methods: Retrospective cohort study of all singleton live-births from Sarda Maternity Hospital (Buenos Aires, Argentina) between 33 and 42 gestational age, using information obtained from a Perinatal Surveillance System (Agustina) dataset between 1996-2001 (n = 25948). Phenotypes small- and large-for-gestational age, stunting and waisting and a composite of neonatal morbidity/mortality (CNMM) were contrasted between the IG-21 standard and Urquia reference. Results: the Urquia 3rd centile value was lower than IG-21 before 37 weeks, but then it surpassed IG-21 until term. Among Sarda , 2.3%, 5.9% and 8.9 were 97th centile, respectively, under the IG-21 standard, while 3.7%, 10.1% and 8.4% were 97th centile, respectively, under the Urquia reference. Stunting and waisting were 16.1% and 0.9%, respectively under IG-21. The IG-21 detection rates of CNMM showed that 28.5%, 19.6% and 8.5% occurred among weight97th centile, respectively, while 21.8%, 14.2% and 8.0% occurred among 97th centile under the Urquia criteria. Newborn weight 97th centile under IG-21 showed higher neonatal CNMM risk compared with Urquia reference. Conclusions: The IG-21 standard identified a higher risk of neonatal morbidity and mortality than the Urquia reference.

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