NEWBORNS WITH SMALL BIRTH WEIGHT IN FIVE CROATIAN REGIONS
Autori:
Lidija Misir-Galić, Josip Grgurić
Sažetak
Sažetak. Cilj: Među terminskom novorođenčadi u pet hrvatskih županija odrediti broj novorođenčadi male porodne mase za gestacijsku dob. Analizirati utjecaj komplikacija i intervencija trudnoće i dobi majke na rađanja djeteta s malom porodnom masom. Metode: Na uzorku živorođene terminske novorođenčadi rođene od 1. siječnja do 31. prosinca 2000. godine iz jednoplodnih trudnoća u pet hrvatskih županija napravljene su tablice centilnih vrijednosti prema kojima su izdvojena novorođenčad s malom porodnom masom za gestacijsku dob. Isključena su novorođenčad s prirođenim malformacijama, nepotpunim podacima i mrtvorođenčad. Analiziran je udio novorođenčadi iz trudnoća s komplikacijama i intervencijama, prema zrelosti majke, završetku poroda te spolu. Rezultati: U pet županija Hrvatske rođeno je 10,9% terminske novorođenčadi nedostatne porodne mase. Djeca male porodne mase za dob češće su rođena iz trudnoća s komplikacijama (p<0,0001), intervencijama (p<0,0001) i trudnoća maloljetnih majki (p<0,0001). Rođenje carskim rezom bilo je češće u odnosu na ostalu terminsku novorođenčad (p<0,0001). Imala su niže srednje vrijednosti porodne mase, duljine i opsega glave od novorođenčadi kontrolne skupine (p<0,0001). Porodna masa terminskog nedostaščeta statistički je manja ako je rođeno iz trudnoće s komplikacijama (p<0,026) i intervencijama (p<0,028) u odnosu na novorođenče male porodne mase iz uredne trudnoće. Varaždinska županija imala je najviši postotak terminske novorođenčadi male porodne mase (13,6%), a Šibensko-kninska županija najniži (5,9%). Srednje vrijednosti porodne mase na 10. centili razlikovale su se među objavljenim standardima rasta u Hrvatskoj i inozemstvu. Zaključak: Svako deseto novorođenče jedne populacije rađa se s malom porodnom masom za gestacijsku dob. Za neke od njih znamo da su rođeni iz trudnoća s komplikacijama ili intervencijama, iz trudnoća maloljetnih majki, ali za velik postotak uzrok ostaje nepoznat.
Summary
Summary. Objective: To determine the frequencies of small birth-weight for gestational age newborns in five Croatian regional maternal hospitals. To analyze the influence of complications and interventions in pregnancies and mother age on births of small-for-gestational age newborns. Methods: Based on the sample of live births full-term newborns from singleton pregnancies born between January 1st and December 31st, 2000, in five Croatian regions, tables of percentiles were created and selected small-for-gestational-age newborns from them. Infants with congenital malformations, births with incomplete records in hospital database and stillbirths were excluded. Percentage of newborns with complication in pregnancy and with interventions was analyzed by mother age, mode of delivery and by sex. Results: In five Croatian regions 10.9% small-for-gestational-age term newborns were born. Small-for-gestational-age newborns were born more often from pregnancy with complications (p<0.0001), with interventions (p<0.0001) and from teenage mothers pregnancies (p<0.0001). Those infants born with Cesarean Section are more frequent in relation to other newborns (p<0.0001). Observed were lower means of birth-weight, birth-length and head circumference compared to those from control group (p<0.0001). Birth-weight of term small-for-gestational age newborns was statistically lower in cases of pregnancy with complications (p<0.026) and interventions (p<0.028) compared to small-for-gestational-age newborns from regular pregnancy. Varaždin region had the highest percentage of term born small-for-gestational-age newborns (13.8%) and Šibenik region the lowest (5.9%). Birth-weight means on the 10th percentile level were different from published standards of growth in Croatia and foreign countries. Conclusion: Each tenth newborn from one population is born with low birth-weight. For some of them we know they came from pregnancies with complications or interventions and from teenage mothers’ pregnancies, but for large part of them the cause is still unknown.
