Perinatology.  2020 Mar;31(1):32-38. 0.14734/PN.2020.31.1.32.

Perinatal Risk Factor and Morbidity in Term Large-for-Gestational-Age Infants according to Classification by Ponderal Index

• Kang YH
• Song ES
• Choi GE
• Hwang IJ
• Choi YY

• KMID: 2507508
• DOI: http://doi.org/0.14734/PN.2020.31.1.32

Abstract

Objective
Large-for-gestational-age (LGA, birth weight ≥90th percentile) infants have increased risks of adverse perinatal outcomes. Further classification within the LGA group enables identification of infants at highest risk for neonatal morbidity. The objective of the study is to investigate the difference of perinatal risk factors and morbidity in LGA infants born at 37–41 weeks of gestation according to classification by the ponderal index (PI).
Methods
195 LGA infants between January 2016 and December 2018, were enrolled in this retrospective study. They were divided into two groups base on PI; symmetric LGA (PI ≤90th percentile) and asymmetric LGA (PI >90th percentile). Neonatal and maternal demographics with clinical characteristics, and neonatal morbidity were compared between two groups.
Results
The gestational age of term LGA infants was 38.6±1.2 weeks and birth weight was 3,963±326 g. Maternal pre-pregnancy body mass index was 25.8±6.6 kg/m2 and diabetes mellitus was 23.6%. Maternal diabetes mellitus and placental infarction were also significantly higher in the asymmetric LGA infants. Asymmetric LGA infants had higher incidence of hypoglycemia, clavicle or humerus fracture and had higher initial hemoglobin and hematocrit levels than the symmetric LGA infants.
Conclusion
In the asymmetric LGA group, maternal diabetes and neonatal morbidity such as clavicle or humerus fracture and hypoglycemia were higher than in the symmetric group. Early identification of fetuses for being the asymmetric LGA gives a chance to optimize management of these newborns associated with increased morbidity. Thus, the combination of birth weight and PI helps a more appropriate parameter than birth weight alone.

Keyword

Birth weight; Morbidity; Risk factors; Term