What birthweight percentile is associated with optimal perinatal mortality and childhood education outcomes? - 28/02/18
Abstract |
Background |
Small for gestational age, defined as birthweight <10th percentile for gestational age, is known to be associated with clinically meaningful impairments in health and development. The effects of variation within the normal range of birthweight percentile on perinatal mortality and childhood education remain less well defined.
Objective |
We sought to quantify the association among birthweight percentile, perinatal mortality, and educational outcomes and to determine the optimal birthweight percentile for those outcomes in Aboriginal and non-Aboriginal Australian children.
Study Design |
This was a retrospective cohort study. Perinatal data for all children born in the Northern Territory, Australia, from 1999 through 2008 were linked to measures of educational attainment at age 8-9 years. Multivariable analysis was used to determine the optimal birthweight percentile for low perinatal mortality and high reading and numeracy scores.
Results |
The birth cohort contained 35,239 births (42% Aboriginal), of which 11,214 had linked and valid education records. Median birthweight percentile was 29.2 in Aboriginal infants and 44.0 in non-Aboriginal infants. The odds of perinatal mortality decreased by 4% with each 1-percentile increase birthweight percentile overall (adjusted odds ratio, 0.96; P = .000) and lowest mortality rates were at the 61st and 78th percentile in Aboriginal and non-Aboriginal infants, respectively. Although birthweights <10th percentile were associated with greatly increased odds of perinatal mortality, the increased risk extended well beyond this cut-off. Birthweight percentile was also positively correlated with scores in reading (P = .000) and numeracy (P = .000). In non-Aboriginal children, reading and numeracy scores peaked at the 66th percentile, but for Aboriginal children there was continuous benefit with increasing birthweight percentile. Birthweight percentile explained 1% of the variation in education outcomes, with much greater variation explained by other perinatal and sociodemographic factors.
Conclusion |
Birthweights between the 50th-93rd percentiles were most consistently associated with both low perinatal mortality and high reading and numeracy scores, suggesting that small for gestational age does not sufficiently capture the risks associated with variation in fetal growth. Our data indicate that the effect of birthweight percentile accounts for 1% of variation in perinatal and education outcomes.
Le texte complet de cet article est disponible en PDF.Key words : Aboriginal, Australia, birthweight, birthweight percentile, data linkage, education, fetal growth, indigenous, National Assessment Program–Literacy and Numeracy, Northern Territory, numeracy, perinatal mortality, pregnancy, reading, school, small for gestational age
Plan
| This project was supported by funds from the National Health and Medical Research Council Partnership Project Grant APP1091491; the Northern Territory Government Departments of Health, Education, and Territory Families; and the Aboriginal Medical Services Alliance Northern Territory. The funding sources did not have a role in the design, analysis, or interpretation of this study. |
|
| The authors report no conflict of interest. |
Vol 218 - N° 2S
P. S712-S724 - février 2018 Retour au numéro
Article précédent
- Fetal growth velocity and body proportion in the assessment of growth
- Liran Hiersch, Nir Melamed
- Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers
- Francesca Gaccioli, Irving L.M.H. Aye, Ulla Sovio, D. Stephen Charnock-Jones, Gordon C.S. Smith
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?