Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births
ObjectivePregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and...
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Frontiers Media S.A.
2025-01-01
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| author | Chun-Heng Kuo Chun-Heng Kuo Chun-Heng Kuo Yi-Ling Wu Chi-Nien Chen Chi-Nien Chen Yu-Ru Lo I-Weng Yen Kang-Chih Fan Yi-Yun Tai Ming-Wei Lin Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Hung-Yuan Li |
| author_facet | Chun-Heng Kuo Chun-Heng Kuo Chun-Heng Kuo Yi-Ling Wu Chi-Nien Chen Chi-Nien Chen Yu-Ru Lo I-Weng Yen Kang-Chih Fan Yi-Yun Tai Ming-Wei Lin Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Hung-Yuan Li |
| author_sort | Chun-Heng Kuo |
| collection | DOAJ |
| description | ObjectivePregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.MethodsUsing the Birth Reporting Databases (2007–2018) linked to Taiwan's National Health Insurance Research Database, we conducted a retrospective nationwide cohort study of singleton neonates delivered between 24 and 42 weeks of gestation. Based on gestational age at delivery, the enrolled neonates were classified into term (37–42 weeks of gestation), late preterm (34–36 weeks of gestation), moderate preterm (32–33 weeks of gestation), very preterm (28–31 weeks of gestation), and extremely preterm (24–27 weeks of gestation). LGA was defined by the 2013 World Health Organization (WHO) growth standard and the Taiwan growth standard. Perinatal outcomes were compared between LGA and AGA neonates across different gestational age groups.ResultsAmong the 1,602,638 neonates, 44,359 were classified as LGA by the 2013 WHO growth standard. Compared to AGA neonates, LGA neonates in term and late preterm groups exhibited higher risks of primary cesarean section, prolonged labor, neonatal hypoglycemia, birth trauma, hypoxic ischemic encephalopathy, jaundice needing phototherapy, respiratory distress, neonatal intensive care unit (NICU) admission, newborn sepsis, and fetal death. However, most of these risks were not increased in moderate, very, and extremely preterm groups. Conversely, being LGA was associated with lower risks of primary cesarean section (very preterm group), jaundice needing phototherapy (moderate and very preterm groups), respiratory distress (moderate and very preterm groups), NICU admission (moderate and very preterm groups), newborn sepsis (very preterm group), retinopathy of prematurity (late, moderate, and very preterm groups), and bronchopulmonary dysplasia (very preterm group). These findings remained consistent when the Taiwan growth standard was applied.ConclusionBeing LGA is associated with increased risks of perinatal complications in term and late preterm neonates, but not in earlier preterm groups. These findings underscore the importance of tailoring management strategies for LGA neonates to consider different degrees of prematurity. |
| format | Article |
| id | doaj-art-9a0d61ff635341a3a389c22d1eb39845 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-9a0d61ff635341a3a389c22d1eb398452025-01-15T05:10:26ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.14987121498712Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature birthsChun-Heng Kuo0Chun-Heng Kuo1Chun-Heng Kuo2Yi-Ling Wu3Chi-Nien Chen4Chi-Nien Chen5Yu-Ru Lo6I-Weng Yen7Kang-Chih Fan8Yi-Yun Tai9Ming-Wei Lin10Chih-Cheng Hsu11Chih-Cheng Hsu12Chih-Cheng Hsu13Chih-Cheng Hsu14Hung-Yuan Li15Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanSchool of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanDepartment of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, TaiwanInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Pediatrics, National Taiwan University College of Medicine, Taipei, TaiwanInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Medical Genetics, National Taiwan University Hospital, Taipei, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, TaiwanInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan0Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan1Department of Health Services Administration, China Medical University, Taichung, Taiwan2National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan3Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanObjectivePregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.MethodsUsing the Birth Reporting Databases (2007–2018) linked to Taiwan's National Health Insurance Research Database, we conducted a retrospective nationwide cohort study of singleton neonates delivered between 24 and 42 weeks of gestation. Based on gestational age at delivery, the enrolled neonates were classified into term (37–42 weeks of gestation), late preterm (34–36 weeks of gestation), moderate preterm (32–33 weeks of gestation), very preterm (28–31 weeks of gestation), and extremely preterm (24–27 weeks of gestation). LGA was defined by the 2013 World Health Organization (WHO) growth standard and the Taiwan growth standard. Perinatal outcomes were compared between LGA and AGA neonates across different gestational age groups.ResultsAmong the 1,602,638 neonates, 44,359 were classified as LGA by the 2013 WHO growth standard. Compared to AGA neonates, LGA neonates in term and late preterm groups exhibited higher risks of primary cesarean section, prolonged labor, neonatal hypoglycemia, birth trauma, hypoxic ischemic encephalopathy, jaundice needing phototherapy, respiratory distress, neonatal intensive care unit (NICU) admission, newborn sepsis, and fetal death. However, most of these risks were not increased in moderate, very, and extremely preterm groups. Conversely, being LGA was associated with lower risks of primary cesarean section (very preterm group), jaundice needing phototherapy (moderate and very preterm groups), respiratory distress (moderate and very preterm groups), NICU admission (moderate and very preterm groups), newborn sepsis (very preterm group), retinopathy of prematurity (late, moderate, and very preterm groups), and bronchopulmonary dysplasia (very preterm group). These findings remained consistent when the Taiwan growth standard was applied.ConclusionBeing LGA is associated with increased risks of perinatal complications in term and late preterm neonates, but not in earlier preterm groups. These findings underscore the importance of tailoring management strategies for LGA neonates to consider different degrees of prematurity.https://www.frontiersin.org/articles/10.3389/fmed.2024.1498712/fulllarge for gestational ageperinatal outcomespretermprematurityfetal deathneonatal death |
| spellingShingle | Chun-Heng Kuo Chun-Heng Kuo Chun-Heng Kuo Yi-Ling Wu Chi-Nien Chen Chi-Nien Chen Yu-Ru Lo I-Weng Yen Kang-Chih Fan Yi-Yun Tai Ming-Wei Lin Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Chih-Cheng Hsu Hung-Yuan Li Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births Frontiers in Medicine large for gestational age perinatal outcomes preterm prematurity fetal death neonatal death |
| title | Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births |
| title_full | Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births |
| title_fullStr | Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births |
| title_full_unstemmed | Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births |
| title_short | Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births |
| title_sort | re evaluating large for gestational age differential effects on perinatal outcomes in term and premature births |
| topic | large for gestational age perinatal outcomes preterm prematurity fetal death neonatal death |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1498712/full |
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