Peruvian reference curves for birth weight according to gestational and their application for identification of new neonatal population with high risk

Abstract

Birth weight according to gestational age has prognostic value and served for the clinical management of the newborn. WHO recommends fetal growth patterns in perinatal centres, because it detects differences by country and living conditions. Objectives. Get a Peruvian reference curve for birth weigth according to gestational age (RC-BWGA), following the criteria proposed by WHO and analyze their influence in identifying high-risk groups compared with Lubchenco curves. Material and methods: Was enrolled prospectively to all new births (NB) in 2005 in 29 hospitals of the Ministry of Health from Peru using the Perinatal Information System 2000. Results: 50 568 NB were included of 99 439 births, their birth weight mean was 3011-3506 g and its 10 percentile was 2435-3030 g at 37 and 42 weeks respectively; that were significantly higher than those of Lubchenco. The multiparity, high maternal stature, male and birth on the coast were associated with an increase birth weight between weeks 36 to 42. The Peruvian RC-BWGA diagnosed 10.1% small for gestational age newborns (SGA-NB) versus 4.1% identifying with Lubchenco curve (p<0.01). The new SGA-NB indentified showed increased morbidity (OR: 1.47, p<0.05) and mortality (OR: 15.6, p<0.01) than those of normal weight. Conclusions. We found RC-BWGA in selected Peruvian population and correction factors for parity, maternal height, sex and natural region. We showed that use of Lubchenco curve underestimates the number of SGA. We recommended use the RC-BWGA in the hospitals of the Peruvian Ministry of Health.