Menu

A+ A A-

Download article

DOI: https://doi.org/10.22263/2312-4156.2023.1.57

V.A. Prylutskaya, T.P. Pavlovich
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
Belarusian State Medical University, Minsk, Republic of Belarus

Vestnik VGMU. 2023;22(1):57-66.

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.

References

1. Cyganek K, Skupien J, Katra B, Hebda-Szydlo A, Janas I, Trznadel-Morawska I, et al. Risk of macrosomia remains glucose-dependent in a cohort of women with pregestational type 1 diabetes and good glycemic control. Endocrine. 2017 Feb;55(2):447-55. doi: http://dx.doi.org/10.1007/s12020-016-1134-z
2. Hauffe F, Schaefer-Graf UM, Fauzan R, Schohe AL, Scholle D, Sedlacek L, et al. Higher rates of large-for-gestational-age newborns mediated by excess maternal weight gain in pregnancies with Type 1 diabetes and use of continuous subcutaneous insulin infusion vs multiple dose insulin injection. Diabet Med. 2019 Feb;36(2):158-66. doi: http://dx.doi.org/10.1111/dme.13861
3. Desoye G, Herrera E. Adipose tissue development and lipid metabolism in the human fetus: The 2020 perspective focusing on maternal diabetes and obesity. Prog Lipid Res. 2021 Jan;81:101082. doi: http://dx.doi.org/10.1016/j.plipres.2020.101082
4. Persson M, Pasupathy D, Hanson U, Norman M. Disproportionate body composition and perinatal outcome in large-for-gestational-age infants to mothers with type 1 diabetes. BJOG. 2012 Apr;119(5):565-72. doi: http://dx.doi.org/10.1111/j.1471-0528.2012.03277.x
5. Prilutskaya VA, Sukalo AV, Pavlovets MV. Peculiarities of adaptation of newborn babies from mothers with type 1 diabetes mellitus and excessive body weight. Reproduktiv Zdorov'e Vostoch Evropa. 2018;8(3):352-60. (In Russ.)
6. Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014 Sep;384(9946):857-68. doi: http://dx.doi.org/10.1016/S0140-6736(14)60932-6
7. Papageorghiou AT, Kennedy SH, Salomon LJ, Altman DG, Ohuma EO, Stones W, et al. The INTERGROWTH-21st fetal growth standards: toward the global integration of pregnancy and pediatric care. Am J Obstet Gynecol. 2018 Feb;218(2S):S630-S640. doi: http://dx.doi.org/10.1016/j.ajog.2018.01.011
8. Choi SKY, Gordon A, Hilder L, Henry A, Hyett JA, Brew BK, et al. Performance of six birth-weight and estimated-fetal-weight standards for predicting adverse perinatal outcome: a 10-year nationwide population-based study. Ultrasound Obstet Gynecol. 2021 Aug;58(2):264-277. doi: http://dx.doi.org/10.1002/uog.22151
9. Vieira MC, Relph S, Persson M, Seed PT, Pasupathy D. Determination of birth-weight centile thresholds associated with adverse perinatal outcomes using population, customised, and Intergrowth charts: A Swedish population-based cohort study. PLoS Med. 2019 Sep;16(9):e1002902. doi: http://dx.doi.org/10.1371/journal.pmed.1002902
10. WHO Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world’s children. Geneva: WHO; 2010. Available from: https://cdn.who.int/media/docs/default-source/child-growth/child-growth-standards/software/anthro-pc-manual-v322.pdf?sfvrsn=c4e76522_2. [Accessed 27th January 2023].
11. The Global Health network. Available from: https://intergrowth21.tghn.org/standards-tools/. [Accessed 27th January 2023].
12. Meek CL, Corcoy R, Asztalos E, Kusinski LC, López E, Feig DS, et al. Which growth standards should be used to identify large- and small-for-gestational age infants of mothers with type 1 diabetes? A pre-specified analysis of the CONCEPTT trial. BMC Pregnancy Childbirth. 2021 Jan;21(1):96. doi: http://dx.doi.org/10.1186/s12884-021-03554-6
13. Jakubowski1 D, Salloum1 D, Maciejewski M, Bednarek-Jędrzejek M, Kajdy A, Cymbaluk-Płoska A, et al. Comparison of application of Fenton, Intergrowth-21st and WHO growth charts in a population of Polish newborns. Clin Exp Obstet Gynecol. 2021;48(4):949-54. doi: http://dx.doi.org/10.31083/j.ceog4804150

Information about authors:
V.A. Prylutskaya – Candidate of Medical Sciences, associate professor of the 1st Chair of Childhood Diseases, Belarusian State Medical University, https://orcid.org/0000-0002-1469-0060
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. ‒ Verаnika A. Prylutskaya;
T.P. Pavlovich – Candidate of Medical Sciences, associate professor, head of the Chair of Public Health and Health Care, Belarusian State Medical University, https://orcid.org/0000-0002-2551-453X

Поиск по сайту