Résumé :
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[BDSP. Notice produite par INIST-CNRS R0xrkI9s. Diffusion soumise à autorisation]. Contemporary fetal growth standards are created by using theoretical properties (percentiles) of birth weight (for gestational age) distributions. The authors used a clinically relevant, outcome-based methodology to determine if separate fetal growth standards are required for singletons and twins. All singleton and twin livebirths between 36 and 42 weeks'gestation in the United States (1995-2002) were included, after exclusions for missing information and other factors (n=17,811,922). A birth weight range was identified, at each gestational age, over which serious neonatal morbidity and neonatal mortality rates were lowest. Among singleton males at 40 weeks, serious neonatal morbidity/mortality rates were lowest between 3,012 g (95% confidence interval (Cl) : 3,008,3,018) and 3,978 g (95% Cl : 3,976,3,980). The low end of this optimal birth weight range for females was 37 g (95% Cl : 21,53) less. The low optimal birth weight was 152 g (95% Cl : 121,183) less for twins compared with singletons. No differences were observed in low optimal birth weight by period (1999-2002 vs. 1995-1998), but small differences were observed for maternal education, race, parity, age, and smoking status. Patterns of birth weight-specific serious neonatal morbidity/neonatal mortality support the need for plurality-specific fetal growth standards.
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