Contributors: Enfermería y Fisioterapia; Materno-Infantil y Radiología; [Fernandez-Alba, Juan Jesus] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain. Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA). Fundación Cádiz - Hospital Universitario Puerto del Mar, 9º planta. Avda. Ana de Viya, 21 - 11009, Cadiz, Spain.; [Castillo Lara, Maria] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain; [Sanchez Mera, Raquel] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain.; [Aragon Baizan, Sara] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain.; [Gonzalez Macias, Carmen] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain.; [Quintero Prado, Rocio] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain; [Vilar Sanchez, Angel] Department of Obstetrics and Gynaecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain.; [Jimenez Heras, Jose Manuel] Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA). Fundación Cádiz - Hospital Universitario Puerto del Mar, 9º planta. Avda. Ana de Viya, 21 - 11009, Cadiz, Spain.
نبذة مختصرة : Background Hypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information. Objective The objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP. Method A comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index th centile or a ponderal index th centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden’s index and probability ratios. Results The study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p th centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86–12.77) vs. 3.75 (95% CI: 1.49–9.43)) (DOR: 5.56 (95% CI: 1.82–16.98) vs. 4.84 (95% CI: 1.51–15.54)) Even when using Ponderal index (th centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11–5.05) vs. 1.68 (95% CI: 0.70–4.03))(DOR 2.62 (95% CI: 1.00–6.87) vs. 1.90 (95% CI: 0.61–5.92)). Conclusion In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st.
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