İlknur ÇÖL MADENDAĞ, Mefkure ERASLAN ŞAHİN

Gebelik yaşına göre büyük doğum ağırlığı bulunan komplike olmayan term gebelerde doğum ağırlığı persentillerinin perinatal sonuçlar ile ilişkisinin değerlendirilmesi

Amaç: Çalışmanın amacı büyük doğum ağırlığı (LGA) olan (gebelik yaşına göre doğum ağırlığı >%90) ve doğum ağırlığı 90 persentile yakın ancak altında (%90-80) olan olguların başta ölü doğum olmak üzere perinatal sonuçlarını araştırarak, bu verileri ülkemiz literatürüne kazandırmaktır.Gereç ve Yöntem: Tersiyer bir merkezde bir yıllık sürede toplam 7800 doğum yapan hasta ve bebek dosyaları incelenerek yapılmıştır. Toplam 3 grup oluşturuldu. 1) doğum ağırlığı > %90 olanlar (LGA grubu), 2) doğum ağırlığı %90-%80 olanlar 3) doğum ağırlığı %79-%10 (kontrol grubu). Gruplar arasında maternal ve yenidoğan kötü sonuçları açısından karşılaştırma yapıldı.Bulgular: Çalışmaya dışlanma kriterlerine göre hastalar seçildikten sonra toplam 4286 hasta dahil edildi. Hastaların 234’ü LGA, 356’sı %80-90 persentil grubunda ve 3696’sı kontrol grubundaydı. Maternal yaş ve sezaryen doğum oranı LGA grubunda en yüksekti. Yenidoğan ünitesine başvuru oranı LGA ve 80-90 persentil grubunda benzer olmak üzere kontrol grubundan çok daha yüksek idi. Mekanik ventilasyon LGA ve 80-90 persentil grubunda kontrol grubuna göre daha yüksekti. Yenidoğan sepsisi, RDS ve klavikula kırık oranları LGA ve 80-90 persentil grubunda kontrol grubuna göre hafif daha yüksekti fakat bu fark istatistiksel olarak anlamlı değildi. Sonuç: Bu çalışma ile doğum kilosuna göre 80-90 persentil arasında olan yenidoğanlarında morbiditesinin yüksek olduğu ve yenidoğan yoğun bakım ihtiyacının fazla olduğu bulunmuştur.

Anahtar Kelimeler:

LGA, neonatal morbidite, neonatal mortalite, iri bebek

Evaluation of the relationship between birth weight percentiles and perinatal outcomes in uncomplicated term pregnant women with large birth weight according to gestational age

Purpose: The aim of this article is to investigate the effect of large birth weight (LGA) on adverse neonatal outcomes, especially on the effect of stillbirth. Yet another hypothesis is; Increased adverse neonatal outcomes of infants whose birth weight is close to 90th percentile, but less than 90% (90-80%). In this study, our aim is to investigate and compare the adverse neonatal outcomes of infants whose birth weight is 90-80 percentile and to gain morbidity and mortality rate in our country's literature.Materials and Methods: A total of 7800 births and infant files were examined in a tertiary center within a year. A total of 3 groups were formed. 1) birth weight> 90% (LGA group), 2) birth weight 90-80% 3) birth weight 79-10% (control group). The comparison of maternal and neonatal outcomes between groups was made.Results: A total of 4286 patients met the study criteria; 234 were in the LGA group, 356 in the 80-90 percentile group and 3696 in the control group. Maternal age and cesarean delivery rate were highest in LGA group. The rate of admission to the neonatal unit was much higher than in the control group, similar in the LGA and 80-90 percentile groups. Mechanical ventilation was higher in LGA and 80-90 percentile groups than in the control group. Neonatal sepsis, RDS and clavicle fracture rates were slightly higher in LGA and 80-90 percentile groups compared to control group, but this difference was not statistically significant. Conclusion: It was found that neonates who are between 80-90 percentiles in terms of birth weight have high morbidity and need for neonatal intensive care.

Keywords:

LGA, neonatal morbidity, neonatal mortality, large baby,

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