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Birth weight and gestation as indices of immaturity


, : Birth weight and gestation as indices of immaturity. Amer J Dis Children 109(1): 43-57

The study is based on 7,447 single white live births and 2,161 single Negro live births from an extensive Child Development Study in Oakland, Calif., supplemented by data based on over 400,000 birth and death certificates of a 3-year cohort of births in New York City. The births were divided into 5 subgroups according to birth weight and gestation. The first 4 groups constitute the immature; group V, the mature. The following findings are recorded The total incidence of immaturity and that of groups I and II are nearly identical for boys and girls. However, births fulfilling the birth weight but not the gestation criterion (group III) are relatively more frequent among girls while those meeting the gestation but not the birth weight criterion (group IV) are relatively more numerous among boys. The overall incidence of immaturity among Negro births is double that of white births but the relative distribution of the immature in the 4 subgroups and the differences between the sexes are nearly the same for the 2 races. The 4 subgroups of the immature are distinguishable in their ability to survive the first month of life. There is a threefold increase in the neonatal mortality rate for those fulfilling only the gestation criterion (group IV); the rate is at least doubled again for the infants in group HI; and there is a further threefold increase for group II infants. The neonatal mortality rates for Negroes are lower than those for whites in each of the 4 subgroups of the immature including group IV. The rate among the mature infants (group V) is considerably higher for Negroes. The neonatal mortality rate for girls is lower than for boys in each of the immature and in the mature groups. The advantage in mortality of the girls was greatest for group III. The handicap in mortality of the immature persists past the neonatal period. Even the most favored of the immature infants (group IV) continue to have higher rates in the post neonatal period and in the second year of life than the mature infants of group V. The incidence of congenital anomalies and especially of severe anomalies is higher for the immature than for the mature infants. But the immature contribute only about 11% of the total anomalies and 17% of the severe anomalies. The most striking difference was noted between group II and III. The small infants of long gestation (group HI) have relatively many more severe anomalies than the small infants of short gestation (group II). The latter, however, have higher neonatal mortality rates. The differences persist when the 2 groups are equalized for birth weight and sex distribution. The study indicates the desirability that births be investigated by means of a cross classification of birth weight and gestational age. The term immature is suggested for infants fulfilling 1 or the other or both of the 2 usual criteria of prematurity.

US$19.90

DOI: 10.1001/archpedi.1965.02090020045005


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