Under diagnosis of fetal growth restriction by the new growth curves of the Chilean Ministry of Health
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Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Abstract
Background: Fetal growth restriction (FGR) is associated with increased risk of perinatal morbidity or death, Nationwide implementation of new fetal growth charts, requires a lower fetal weight for the diagnosis of FGR, compared to previous ones. This may lead to an under diagnosis of FGR in a large proportion of neonates. Aim: To compare the morbidity, mortality and anthropometry of neonates with FGR, diagnosed by MINSAL and Juez curves, with normal weight newborns in the same period (2000-2004). Material and methods. Revision of medical records of all births occurring in a maternity hospital between 2000 and 2004. The number of neonatal deaths, and the presence of hyperbilirubinemia, polyglobulia, hypoglycemia and hypotbermia, were compared among children classified to be below percentile 10 of fetal growth according to both growth charts. Results. FGR was diagnosed in 4,4% (502/11.289) and 9% (1.029/11.289) of newborns by MINSAL and Juez curves respectively. Compared to normal weight controls, the 527 newborns without FGR according to AHNSAL curves, but below percentile 10 of Juez curves, bad an odds ratio (OR) for polyglobulina of 8.14 (95016 confidence, intervals (G): 1.01-65-34), an OR for neonatal hypoglycemia of 5.10 (95% CT 1.11-23.39) and an OR for a ponderal index below 10(th) percentile of 10.98 (95% CI- 6.84-17.64). Conclusions: Newborns without a diagnosis of FGR by MINSAL curves but below 10(th) percentile by Juez curves, have neonatal outcomes suggesting a true FGR. Juez curves should be maintained as a standard for the evaluation of fetal growth, in our population (Rev Med Chile 2007- 135.- 436-42).
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Keywords
fetal development, fetal viability, perinatal care, perinatal mortality, INTRAUTERINE GROWTH, RETARDATION