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Introdução à Medicina II Class 16 Advisers : Mário Dinis-Ribeiro Ricardo Santos

Birth weight references throughout Western Europe: Characterization of its usage by neonatologists. Introdução à Medicina II Class 16 Advisers : Mário Dinis-Ribeiro Ricardo Santos Francisco Mourão. SUMMARY. Introduction Aim Methods Results Discussion / Conclusion. INTRODUCTION.

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Introdução à Medicina II Class 16 Advisers : Mário Dinis-Ribeiro Ricardo Santos

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  1. Birth weight references throughout Western Europe: Characterization of its usage by neonatologists • Introdução à Medicina II • Class 16 • Advisers: • MárioDinis-Ribeiro • Ricardo Santos • Francisco Mourão fmupturma16@googlegroups.com

  2. SUMMARY • Introduction • Aim • Methods • Results • Discussion/Conclusion fmupturma16@googlegroups.com

  3. INTRODUCTION • Over the past years, there has been several studies about birth weight curves. • They contributed to define normal and abnormal reference values [1], that are useful for clinical, public health and investigational purposes. [2] 1987 Present [3] 1- McIntire DD, Bloom SL, et al. Birth weight in Relation to Morbidity and Mortality among Newborn Infants. N Engl J Med 1999 2- Brenner WE, Edelman DA, Hendricks CH. A standard of fetal growth for the United States of America. AM J Obstet Gynecol 1976 3- Fok, T F, So, H K, et al. Updated gestational age specific birth weight, crown-hell length, and head circumference of Chinese newborns. Arch Dis Child Fetal Neonatal 2003 fmupturma16@googlegroups.com

  4. INTRODUCTION 4 - Gardosi J, Mongelli M, Wilcox M, Chang A. An adjustable fetal weight standard Ultrasound Obstet Gynecol 1995 5 - Merialdi M, Caulfield LE, Zavaleta N, et al. Fetal growth in Peru: comparisons with international fetal size charts and implications for fetal growth assessment Ultrasound Obstet Gynecol. 2005 fmupturma16@googlegroups.com

  5. INTRODUCTION 6 - Kramer Michael, et al. A new and Improved Population-Based Canadian Reference for Birth Weight for Gestational Age Pediatics 2001 7 - Zhang J, Bowes WA Jr. Birth-weight-for-gestational-age patterns by race, sex, and parity in the United States population. Obstet Gynecology 1995 fmupturma16@googlegroups.com

  6. INTRODUCTION Dissimilaritiesinbirthweightcurves Wrong Diagnoses Diseases related with growth restriction [8] or with large birth weight. [9] [10] 8 - Zhang Jun, et al. Defining normal and abnormal fetal growth: promises and challenges. American Journal of Obstetrics & Gynacology 2010 9 - Teresa To, Jun Guan, Chengning Wang, et al. Is large birth weight associated with asthma risk in early childhood? ADC 2010 10 - Tanis R Fenton, A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format, 1Department of Community Health Sciences, Faculty of Medicine, University of Calgary 2003 fmupturma16@googlegroups.com

  7. INTRODUCTION Alexander, G. (1996) [11] 11 - Alexander, G., et al., A United States national reference for fetal growth. Obstet Gynecol, 1996. 87: p. 163 - 168. fmupturma16@googlegroups.com

  8. INTRODUCTION Fenton, T. (2003) “The postnatal growth data of 4 of the infant cohorts from the National Institute of Child Health and Human Development Neonatal Research Network superimposed on the new chart.” [12] 12 - Fenton, T., A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatrics, 2003. 3(1): p. 13. fmupturma16@googlegroups.com

  9. INTRODUCTION Olsen, I.E (2010) 13 - Olsen, I.E., New Intrauterine Growth Curves Based on United States Data. Pediatrics, 2010. 125(2): p. e214-e224.

  10. SUMMARY • Introduction • Aim • Methods • Results • Discussion/Conclusion fmupturma16@googlegroups.com

  11. AIM fmupturma16@googlegroups.com

  12. SUMMARY • Introduction • Aim • Methods • Results • Discussion/Conclusion fmupturma16@googlegroups.com

  13. METHODS • Selected population: Neonatologists working on Western European Hospitals with >1500 births-per-year fmupturma16@googlegroups.com

  14. METHODS Western Europeancountries selected by UNESCO definition fmupturma16@googlegroups.com

  15. METHODS • Analyze the number of births per hospital If this information was not included on their online data bases fmupturma16@googlegroups.com

  16. METHODS • Select the Western European Hospitals that meet our requirements. Overthan1500birthsperyear Lessthan1500birthsperyear Selectedrandomly 20 hospitals per country (whenthecountryhas more than 20 hospitals) Eliminated fmupturma16@googlegroups.com

  17. METHODS

  18. METHODS • Contact the neonatology department of each selected Hospital, sending a online survey. fmupturma16@googlegroups.com

  19. METHODS • If the neonatology department of each hospital did not answer… After another week without answer After one week fmupturma16@googlegroups.com

  20. METHODS - Survey fmupturma16@googlegroups.com

  21. METHODS fmupturma16@googlegroups.com

  22. METHODS • Analyze the results and discuss. Analysis of the data collected via statistical methods PASW Statistics 18 Microsoft Office Excel 2007 Graphing fmupturma16@googlegroups.com

  23. SUMMARY • Introduction • Aim • Methods • Results • Discussion/Conclusion fmupturma16@googlegroups.com

  24. RESULTS fmupturma16@googlegroups.com

  25. RESULTS n = 28 n =2 not responded n = 2 n = 3 n = 1 fmupturma16@googlegroups.com

  26. Births per Hospital: RESULTS n=36 n=4 n=8 fmupturma16@googlegroups.com

  27. RESULTS n=2 n=4 n=30 fmupturma16@googlegroups.com

  28. In 94% ofthehospitalsthereisoneor more recommendedbirth weight standards/reference table. Allthehospitals use atleastonebirth weight standards/reference table. RESULTS fmupturma16@googlegroups.com

  29. RESULTS Which birth weight standards/reference tables do you use? fmupturma16@googlegroups.com

  30. RESULTS Which birth weight standards/reference tables do you use? “OTHER” - “UK – World Health Organization growth chart” - “CDC growth chart, 2000, USA” - “Niklasson A. and Karlberg P 1999, Sveeden” - “BMUS approved Chitty charts based on the Hadlock formula” fmupturma16@googlegroups.com

  31. RESULTS n=10 n=10 n=8 n=3 n=3 n=1 It has been used for many years We have done some research and it is considered the most suitable No opinion It is the hospital/ department policy It was produced for our population Other reason

  32. SUMMARY • Introduction • Aim • Methods • Results • Discussion/Conclusion fmupturma16@googlegroups.com

  33. DISCUSSION/ CONCLUSION fmupturma16@googlegroups.com

  34. DISCUSSION/ CONCLUSION fmupturma16@googlegroups.com

  35. DISCUSSION/CONCLUSION Reasons behind the large percentage of acritical use of the Birth weight references… fmupturma16@googlegroups.com

  36. DISCUSSION/CONCLUSION PossibleBias fmupturma16@googlegroups.com

  37. DISCUSSION/CONCLUSION Thegreatmajorityofthepeoplewhoansweredhadclinicalfunctionsinthe hospital; InPortugal theLubchenkocurve isthemostused, whileintheotherscountriestheyprefernationalandother curves; Thegreatmajorityansweredthatthey do not use appropriatlythe curves to thenewborn/maternal variables, inspiteconsideringthisanimportantmatter. fmupturma16@googlegroups.com

  38. ACKNOWLEDGEMENTS • Professor Doutor Altamiro Pereira • Professor Doutor Mário Dinis-Ribeiro • Doutor Ricardo Santos • Francisco Mourão • Eng.º Jorge Jácome • CIDES fmupturma16@googlegroups.com

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