[Identification of a high-risk new neonatal population with Peruvian fetal growth curve].

BACKGROUND

Early detection of risk factors in newborns is an essential aim in modern perinatology.

OBJECTIVE

To know quantity of small for gestational age newborns by means of Peruvian curves of intrauterine growth, and to study them morbidity-mortality risks associated to a new neonates group. MATEIRIAL AND

METHODS

Prospective, analytic, and case-control study. There were 95,751 neonates born in 2005, from 29 hospitals of Ministerio de Salud del Perú; they were classified by weight using Peruvian and Lubchenco growth curves. Percent distribution was compared (p < 0.05). Risks of morbidity-mortality in additional small for gestational age newborns (called new) were compared with adecuate for gestational age (37 to 42 weeks; IC 95%). Data Perinatal System was used.

RESULTS

Large for gestational age newborns meaningfully decreases from 14.3 to 11.4%, as adequate for gestational age newborns from 81.7 to 78.5%, and small for gestational age newborns raises from 4.1 to 10.1%. There were 9,664 small for gestational age newborns using Peruvian curve, and 3,899 using Lubchenco one. The difference of 5,765 newborns (6% of total population) corresponds to new small for gestational age newborns that had this risks: neonatal mortality (OR: 15.6); metabolic disorders (OR: 2.2); congenital malformations (OR: 2.1); infections (OR: 2); respiratory distress syndrome (OR: 1.8); perinatal asphyxia (OR: 1.7), and neonatal morbidity (OR: 1.5).

CONCLUSIONS

Lubchenco's curve overestimate large for gestational age newborns and underestimate small for gestational age newborns; due to this is a poor pattern to apply in Peruvian newborns. New small for gestational age newborns are a group with high morbidity-mortality risk.