Association of newborn diseases with weight/length ratio and the adequacy of weight for gestational age

Bertagnon, José Ricardo Dias; Rocha, Marcos da Cruz; Kuraim, Gabriela Alba; Guidara, Rosângela; Novo, Neil Ferreira

doi:10.1590/S1679-45082011AO2086

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Original Article • EINSEinstein (São Paulo) 9 (3) • Jul-Sep 2011 • https://doi.org/10.1590/S1679-45082011AO2086 copy

Association of newborn diseases with weight/length ratio and the adequacy of weight for gestational age

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To compare the frequencies of newborn diseases in those newborns classified according to a weight/length rate and those classified by the adequacy weight for gestational age.

Methods:

A retrospective cross-sectional study by record assessment was carried out enclosing all the live newborns at Hospital Geral do Grajaú, from September to December, 2009 (n =577) classified according to the rate weight/length and also to the adequacy weight for gestational age. The 10 and 90 percentiles of the weight/length distribution, now designated as “indices” were calculated leading to the following classification: low index, for newborns below 54.8 g/cm; high index, for those over 75.8 g/cm; and average index, for the remaining newborns. According to the adequacy weight for gestational age the newborns were designated as pre-term for gestational age; term small for gestational age; appropriate term and large term. In this sample there were no small and large pre-term or post-term newborns. Major diseases were related to the index and adequacy extracts by the χ² test for a contingency table.

Results:

A significant association was found among low index, pre-term for gestational age newborns and term small for gestational age; between average index and appropriate for gestational age term newborns; and high index with large term appropriate for gestational age newborns (p< 0.001). Hypoglycemia (3.4%) was associated to both low and high indices, to appropriate for gestational age preterm newborns and to small for gestational age term newborns. Sepsis (3.1%) was associated to both low index and pre-term appropriate for gestational age newborns. The respiratory distress syndrome (1.3%) was associated to low index and pre-term appropriate for gestational age newborns. Other respiratory distress syndromes (3.8%) were associated to low and high indices but not to the adequacy for gestational age classification. Jaundice (14.9%) was not associated to the studied classifications. Perinatal asphyxia (12.6%) was associated to low index and pre-term newborns.

Conclusion:

The weight/length index may represent a contribution to the newborn risk classification being similar to that of the weight for gestational age adequacy, for the studied diseases.

Keywords:
Gestational age; Infant, newborn; Fetal weight; Birthweight

Institution	n	Weight/height index 10^th percentile (LI)	Weight/height index 90^th percentile (HI)	Mean	Standard deviation (±)
HGG	577	54.8	75.8	64.67	7.65
Other	4634	56.3	74.2	65.11	7.83

Classification	PT AGA		T SGA		T AGA		T LGA		Total
Classification	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%
LI	30	44.1	23	33.8	15	22.1	0	0.0	68	10.1
MI	5	11.0	33	72.0	394	86.9	21	4.8	454	80.2
HI	0	0.0	0	0.0	18	32.7	37	61.8	55	9.75
Total	35	6.0	56	9.7	427	74.0	59	10.2	577	100

Index	Hypogl.		Sepsis		RDS		Jaundice		Other Resp. Distress		Asphyxia		Total
Index	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%
LI	6	8.8	13	19.1	7	10.3	8	14.0	7	10.2	14	20.6	68	100
MI	9	2.0	1	0.2	1	0.22	68	16.0	12	2.6	49	10.8	454	100
HI	5	5.4	2	3.6	0	0.0	10	18.2	3	5.4	10	18.2	55	100
Total	20	3.1	16	2.7	8	1.3	86	15.2	22	3.8	73	12.6	577	100
χ²	13.97		78.34		44.66		0.99		9.85		6.77
p-value	0.0009		<0.0001		<0.0001		0.6		0.007		0.03

Range	Hypoglyc		Sepsis		RDS		Jaundiceresp.		Other Resp. Distress		Asphyxia		Total
Range	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%	n	RF%
PT AGA	6	17.1	12	34.2	8	22.8	10	28.5	4	11.4	14	40.0	35	100
FT SGA	7	12.5	3	3.6	0	0.0	9	16.1	2	3.6	5	8.9	56	100
FT AGA	3	0.7	1	0.2	0	0.0	57	13.3	14	3.3	46	10.8	427	100
FT LGA	4	6.8	1	1.7	0.0	0.0	10	17.2	2	3.4	8	13.7	59	100
Total	20	3.4	18	3.1	8	1.3	86	14.9	22	3.8	73	12.6	577	100
χ²	36.5		139.5		125.6		6.24		5.9		25.8
p value	<0.0001		<0.0001		<0.0001		0.1		0.11		<0.001

Disease	n	%	index/disease (χ²)	p value	Range/disease (χ²)	p value
Hypoglycemia	20	3.4	13.97	0.0009	36.5	<0.0001
Sepsis	18	3.1	78.34	0.0001	139.5	<0.0001
RDS	8	1.3	44.66	0.0001	125.6	<0.0001
Jaundice	86	14.9	0.99	0.6	6.24	<0.1
Other Resp. Distress	22	3.8	9.85	0.007	5.9	0.1
Asphyxia	73	12.6	6.77	0.03	25.8	0.001

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[1] Correspondence: José Ricardo Dias Bertagnon – Rua Francisco Romeiro Sobrinho, 171 – Chácara Santo Antonio – CEP 04710-180 – Sao Paulo (SP), Brazil – Tel.: (11) 5181-5330 – E-mail: joserimed@uol.com.br