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Abstract：
BACKGROUND: Birth-weight is an important determinant of perinatal outcome with low birth-weight being a particular risk factor for adverse consequences.
OBJECTIVE: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies.
METHODS: This was a retrospective cohort study of singleton term births at the Mater Mother\'s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤-12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile.
RESULTS: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06-4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30-1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60-7.75).
CONCLUSIONS: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.
OBJECTIVE: To investigate the impact of neonatal sex, mode of birth and gestational age at birth according to birth-weight centile on serious adverse neonatal outcomes in singleton term pregnancies.
METHODS: This was a retrospective cohort study of singleton term births at the Mater Mother\'s Hospital, Brisbane, Australia. Serious adverse neonatal outcome was defined as a composite of severe acidosis at birth (pH ≤7.0 and/or lactate ≥6 mmol/L and/or base excess ≤-12 mmol/L), Apgar <3 at 5 min, neonatal intensive-care unit admission and antepartum or neonatal death. The main exposure variable was birth-weight centile.
RESULTS: Of the 69,210 babies in our study, the overall proportion of serious adverse neonatal outcomes was 9.1% (6327/69,210). Overall, neonates in the <3rd birth-weight centile category had the highest adjusted odds ratio (OR) for serious adverse neonatal outcomes [OR 3.53, 95% confidence interval (CI) 3.06-4.07], whilst those in the ≥97th centile group also had elevated odds (OR 1.51, 95% CI 1.30-1.75). Regardless of birth modality, smaller babies in the <3rd centile group had the highest adjusted OR and predicted probability for serious adverse neonatal outcomes. When stratified by sex, male babies consistently demonstrated a higher predicted probability of serious adverse neonatal outcomes across all birth-weight centiles. The adjusted odds, when stratified by gestational age at birth, were the highest from 37+0 to 38+6 weeks in the <3rd centile group (OR 5.97, 95% CI 4.60-7.75).
CONCLUSIONS: Low and high birth-weights are risk factors for serious adverse neonatal outcomes. The adjusted OR appears to be greatest for babies in the <3rd birth-weight centile group, although an elevated risk was also found in babies within the ≥97th centile category.
摘要：
背景：出生体重是围产期结局的重要决定因素，低出生体重是导致不良后果的特殊危险因素。
目的：调查新生儿性行为的影响，根据出生体重百分位数对单胎足月妊娠新生儿严重不良结局的出生方式和出生胎龄。
方法：这是一项关于母亲医院单胎足月分娩的回顾性队列研究，布里斯班,澳大利亚。严重不良新生儿结局定义为出生时严重酸中毒的复合（pH≤7.0和/或乳酸≥6mmol/L和/或碱过量≤-12mmol/L），5分钟时Apgar<3，新生儿重症监护病房入院和产前或新生儿死亡。主要暴露变量是出生体重百分位数。
结果：在我们研究的69,210名婴儿中，新生儿严重不良结局的总比例为9.1%(6327/69,210).总的来说,<第3出生体重百分位数类别的新生儿在严重不良新生儿结局方面具有最高的调整比值比(OR)[OR3.53,95%置信区间(CI)3.06-4.07],而≥97百分位组患者的几率也升高(OR1.51,95%CI1.30-1.75).不管出生模式如何，<3百分位组的小婴儿出现严重不良新生儿结局的校正OR和预测概率最高.当按性别分层时，男性婴儿在所有出生体重百分位数中始终显示出更高的严重不良新生儿结局的预测概率.调整后的赔率，当按出生时的胎龄分层时，在<第三百分位组的37+0~38+6周最高(OR5.97,95%CI4.60~7.75)。
结论：低出生体重和高出生体重是严重不良新生儿结局的危险因素。调整后的OR值对于<第3出生体重百分位组的婴儿似乎最大，尽管在≥97百分位子类别的婴儿中也发现了升高的风险。
目的：调查新生儿性行为的影响，根据出生体重百分位数对单胎足月妊娠新生儿严重不良结局的出生方式和出生胎龄。
方法：这是一项关于母亲医院单胎足月分娩的回顾性队列研究，布里斯班,澳大利亚。严重不良新生儿结局定义为出生时严重酸中毒的复合（pH≤7.0和/或乳酸≥6mmol/L和/或碱过量≤-12mmol/L），5分钟时Apgar<3，新生儿重症监护病房入院和产前或新生儿死亡。主要暴露变量是出生体重百分位数。
结果：在我们研究的69,210名婴儿中，新生儿严重不良结局的总比例为9.1%(6327/69,210).总的来说,<第3出生体重百分位数类别的新生儿在严重不良新生儿结局方面具有最高的调整比值比(OR)[OR3.53,95%置信区间(CI)3.06-4.07],而≥97百分位组患者的几率也升高(OR1.51,95%CI1.30-1.75).不管出生模式如何，<3百分位组的小婴儿出现严重不良新生儿结局的校正OR和预测概率最高.当按性别分层时，男性婴儿在所有出生体重百分位数中始终显示出更高的严重不良新生儿结局的预测概率.调整后的赔率，当按出生时的胎龄分层时，在<第三百分位组的37+0~38+6周最高(OR5.97,95%CI4.60~7.75)。
结论：低出生体重和高出生体重是严重不良新生儿结局的危险因素。调整后的OR值对于<第3出生体重百分位组的婴儿似乎最大，尽管在≥97百分位子类别的婴儿中也发现了升高的风险。
