introdução à medicina ii class 16 advisers : mário dinis-ribeiro ricardo santos
DESCRIPTION
Birth weight references throughout Western Europe: Characterization of its usage by neonatologists. Introdução à Medicina II Class 16 Advisers : Mário Dinis-Ribeiro Ricardo Santos Francisco Mourão. SUMMARY. Introduction Aim Methods Results Discussion / Conclusion. INTRODUCTION. - PowerPoint PPT PresentationTRANSCRIPT
Birth weight references throughout Western Europe:
Characterization of its usage by neonatologists
Introdução à Medicina IIClass 16Advisers:
• Mário Dinis-Ribeiro• Ricardo Santos• Francisco Mourão
SUMMARY
I. Introduction
II. Aim
III. Methods
IV. Results
V. Discussion/Conclusion
INTRODUCTION
1987 Present
Over the past years, there has been several studies about birth weight curves.
They contributed to define normal and abnormal reference values [1], that are useful for clinical, public health and investigational purposes. [2]
1- McIntire DD, Bloom SL, et al. Birth weight in Relation to Morbidity and Mortality among Newborn Infants. N Engl J Med 19992- Brenner WE, Edelman DA, Hendricks CH. A standard of fetal growth for the United States of America. AM J Obstet Gynecol 19763- Fok, T F, So, H K, et al. Updated gestational age specific birth weight, crown-hell length, and head circumference of Chinese newborns. Arch Dis Child Fetal Neonatal 2003
3
[3]
INTRODUCTION
4 - Gardosi J, Mongelli M, Wilcox M, Chang A. An adjustable fetal weight standard Ultrasound Obstet Gynecol 19955 - Merialdi M, Caulfield LE, Zavaleta N, et al. Fetal growth in Peru: comparisons with international fetal size charts and implications for fetal growth assessment Ultrasound Obstet Gynecol. 2005
INTRODUCTION
6 - Kramer Michael, et al. A new and Improved Population-Based Canadian Reference for Birth Weight for Gestational Age Pediatics 20017 - Zhang J, Bowes WA Jr. Birth-weight-for-gestational-age patterns by race, sex, and parity in the United States population. Obstet Gynecology 1995
INTRODUCTION
8 - Zhang Jun, et al. Defining normal and abnormal fetal growth: promises and challenges. American Journal of Obstetrics & Gynacology 20109 - Teresa To, Jun Guan, Chengning Wang, et al. Is large birth weight associated with asthma risk in early childhood? ADC 201010 - Tanis R Fenton, A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format, 1Department of Community Health Sciences, Faculty of Medicine, University of Calgary 2003
[10]
Dissimilarities in birth weight curves
Wrong Diagnoses
Diseases related with growth restriction [8] or with large birth weight.
[9]
6
11 - Alexander, G., et al., A United States national reference for fetal growth. Obstet Gynecol, 1996. 87: p. 163 - 168.
INTRODUCTION
[11]
Alexander, G. (1996)Alexander, G. (1996)
“The postnatal growth data of 4 of the infant
cohorts from the National Institute of
Child Health and Human Development Neonatal
Research Network superimposed on the
new chart.”
12 - Fenton, T., A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatrics, 2003. 3(1): p. 13.
INTRODUCTION
[12]
Fenton, T. (2003)Fenton, T. (2003)
9 13 - Olsen, I.E., New Intrauterine Growth Curves Based on United States Data. Pediatrics, 2010. 125(2): p. e214-e224.
INTRODUCTIONOlsen, I.E (2010)Olsen, I.E (2010)
SUMMARY
I. Introduction
II. Aim
III. Methods
IV. Results
V. Discussion/Conclusion
SUMMARY
I. Introduction
II. Aim
III. Methods
IV. Results
V. Discussion/Conclusion
METHODSSelected population:
Neonatologists working on Western European Hospitals with >1500 births-per-year
METHODS
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1. Analyze the number of births per hospital
If this information was not included on their online data bases
METHODS
16
2. Select the Western European Hospitals that meet our requirements.
Less than 1500
births per year
Over than 1500
births per year
EliminatedSelected randomly 20 hospitals per country (when the country has more than 20 hospitals) [email protected]
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METHODS
METHODS
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3. Contact the neonatology department of each selected Hospital, sending a online survey.
METHODS
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4. If the neonatology department of each hospital did not answer…
After one week
After another week without answer
METHODS
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5. Analyze the results and discuss.
Analysis of the data collected via
statistical methods
PASW Statistics
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GraphingMicrosoft
Office Excel 2007
SUMMARY
I. Introduction
II. Aim
III. Methods
IV. Results
V. Discussion/Conclusion
CountryNumber of randomized
hospitals selected
Number of answers of each country
Percentage of answers (%)
Belgium 11 1 9
Finland 14 1 7
France 20 1 5
England 20 4 20
North Ireland 5 1 20
Wales 9 4 44
Portugal 20 10 50
Czech Republic 17 4 24
Switzerland 5 2 40
Austria 14 1 7
Scotland 13 1 8
Spain 20 1 5
Ireland 19 2 11
Luxemburg 2 0 0
Norway 14 1 7
Sweden 20 1 5
Denmark 18 2 11
Total 241 37 15
RESULTS
0%10%20%30%40%50%60%70%80%90%
100%
Clinical Administratives Students Both Clinical andAdmnistrarive
Who answered?
26
n = 3 n = 2
n = 28
n = 1
n =2 not responded
RESULTS
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Mean 2949,85
Std Deviation 1118,481
Minimum 1500
Maximum 5500
Births per Hospital:
n=36
n=4
n=8
RESULTS
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Which birth weight standards/reference tables do you use?
““OTHER”OTHER”
- “UK – World Health Organization growth chart”
- “CDC growth chart, 2000, USA”
- “Niklasson A. and Karlberg P 1999, Sveeden”
- “BMUS approved Chitty charts based on the Hadlock formula”
RESULTS
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The main reason behind its use:
It has been used
for many years
It is the hospital/
department policy
It was produced
for our population
We have done some
research and it is considered themost suitable
Other reason No opinion
n=10n=10
n=8
n=3n=3 n=1
SUMMARY
I. Introduction
II. Aim
III. Methods
IV. Results
V. Discussion/Conclusion
DISCUSSION/CONCLUSION
36
Reasons behind the large percentage of acritical use of the Birth weight references…
DISCUSSION/CONCLUSION
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The great majority of the people who answered had clinical functions
in the hospital;
The great majority of the people who answered had clinical functions
in the hospital;
In Portugal the Lubchenko curve is the most used, while in the others
countries they prefer national and other curves;
In Portugal the Lubchenko curve is the most used, while in the others
countries they prefer national and other curves;
The great majority answered that they do not use appropriatly the
curves to the newborn/maternal variables, in spite considering this
an important matter.
The great majority answered that they do not use appropriatly the
curves to the newborn/maternal variables, in spite considering this
an important matter.
Professor Doutor Altamiro Pereira
Professor Doutor Mário Dinis-Ribeiro
Doutor Ricardo Santos
Francisco Mourão
Eng.º Jorge Jácome
CIDES
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ACKNOWLEDGEMENTS