A1 Refereed original research article in a scientific journal
Association between risk of infant death and birth-weight z scores according to gestational age : A nationwide study using the Finnish Medical Birth Register
Authors: Hocquette, Alice; Pulakka, Anna; Metsälä, Johanna; Heikkilä, Katriina; Zeitlin, Jennifer; Kajantie, Eero
Publisher: John-Wiley
Publication year: 2024
Journal: International Journal of Gynecology and Obstetrics
Journal name in source: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Journal acronym: Int J Gynaecol Obstet
Volume: 167
Issue: 3
First page : 1138
Last page: 1145
ISSN: 0020-7292
eISSN: 1879-3479
DOI: https://doi.org/10.1002/ijgo.15772
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Partially Open Access publication channel
Web address : https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.15772
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/457218309
Self-archived copy's licence: CC BY NC ND
Self-archived copy's version: Publisher`s PDF
Objective: To investigate the association between infant mortality and birth weight using estimated fetal weight (EFW) versus birth-weight charts, by gestational age (GA).
Methods: This nationwide population-based study used data from the Finnish Medical Birth Register from 2006 to 2016 on non-malformed singleton live births at 24-41+6 weeks of gestation (N = 563 630). The outcome was death in the first year of life. Mortality risks by birth-weight z score, defined as a continuous variable using Maršál's EFW and Sankilampi's birth-weight charts, were assessed using generalized additive models by GA (24-27+6, 28-31+6, 32-36+6, 37-38+6, 39-41+6 weeks). We calculated z score thresholds associated with a two- and three-fold increased risk of infant death compared with newborns with a birth weight between 0 and 0.675 standard deviations.
Results: The z score thresholds (with corresponding centiles in parentheses) associated with a two-fold increase in infant mortality were: -3.43 (<0.1) at 24-27+6 weeks, -3.46 (<0.1) at 28-31+6 weeks, -1.29 (9.9) at 32-36+6 weeks, -1.18 (11.9) at 37-38+6 weeks, and - 1.34 (9.0) at 39-41+6 weeks according to the EFW chart. These values were - 2.43 (0.8), -2.62 (0.4), -1.34 (9.0), -1.37 (8.5), and - 1.43 (7.6) according to the birth-weight chart.
Conclusion: The association between birth weight and infant mortality varies by GA whichever chart is used, suggesting that different thresholds for the screening of growth anomalies could be used across GA to identify high-risk newborns.
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Funding information in the publication:
This study contributes to research on the consequences of preterm birth by the RECAP Preterm project, supported by the European Union's Horizon 2020 research and innovation program (grant agreement no. 733280). Further funding was received as follows: AH was supported by a PhD grant and a research mobility grant from the EHESP; EK was supported by Academy of Finland (grants 315690, 355514), Finska Läkaresällskapet, Foundation for Cardiovascular Research, Foundation for Pediatric Research, Novo Nordisk Foundation, Signe and Ane Gyllenberg Foundation, Sigrid Jusélius Foundation, and Yrjö Jahnsson Foundation. AP was supported by Juho Vainio Foundation and Signe and Ane Gyllenberg Foundation. KH was supported by Signe and Ane Gyllenberg Foundation and the Finnish Foundation for Pediatric Research. JM was supported by Research Council of Finland (grant 354936). The funders were not involved in conducting the research or writing the paper.
