3.1.2. Lenght and head circumference by GA. Same as the way to calculate birth weight, the choosen function to calculate Lenght and head circumference percentiles by GA from 28-42 weeks:
|
n
|
Phương trình
|
r
|
p
| |
Lenght
|
Both sexses
|
Y = - 0.019.x2 + 2.218.x – 11.690
|
0,94
|
0,0001
|
Male
|
Y = -0,023.x2 +2,656.x – 18,86
|
0,94
|
0,0001
|
Female
|
Y = - 0,021.x2 + 2,507.x – 16,353
|
0,93
|
0,0001
|
Head circumference
|
Both sexses
|
Y = - 0,02x2 + 2,058x - 16,401
|
0,93
|
<0,001
|
Male
|
Y = -0,02.x2 + 2,101.x – 17,221
|
0,93
|
0,0001
|
Female
|
Y = - 0,022.x2 + 2,189.x – 18,65
|
0,92
|
0,0001
|
Base on the recipe of calculating pecentiles, we had table and chart as follow:
Table 3.3.Both sexes, male, female birth lenght Percentiles
by GA
GA
|
n
|
SD
|
Percentiles
|
3rd
|
5th
|
10th
|
50th
|
90th
|
95th
|
97th
|
Both sexes
|
28
|
108
|
1.5
|
34.5
|
34.9
|
35.4
|
37.3
|
39.2
|
39.8
|
40.1
|
29
|
126
|
1.5
|
35.8
|
36.2
|
36.7
|
38.6
|
40.6
|
41.1
|
41.5
|
30
|
154
|
1.5
|
37.1
|
37.5
|
38.0
|
39.9
|
41.9
|
42.4
|
42.8
|
31
|
209
|
1.5
|
38.4
|
38.7
|
39.3
|
41.2
|
43.1
|
43.6
|
44.0
|
32
|
238
|
1.5
|
39.6
|
39.9
|
40.5
|
42.4
|
44.3
|
44.9
|
45.2
|
33
|
250
|
1.5
|
40.7
|
41.1
|
41.6
|
43.6
|
45.5
|
46.0
|
46.4
|
34
|
284
|
1.5
|
41.8
|
42.2
|
42.7
|
44.7
|
46.6
|
47.1
|
47.5
|
35
|
234
|
1.5
|
42.9
|
43.3
|
43.8
|
45.7
|
47.7
|
48.2
|
48.6
|
36
|
213
|
1.5
|
44.0
|
44.3
|
44.9
|
46.8
|
48.7
|
49.2
|
49.6
|
37
|
227
|
1.6
|
44.8
|
45.1
|
45.8
|
47.8
|
49.8
|
50.4
|
50.8
|
38
|
345
|
1.7
|
45.5
|
45.9
|
46.6
|
48.7
|
50.9
|
51.5
|
51.9
|
39
|
495
|
1.7
|
46.4
|
46.8
|
47.5
|
49.6
|
51.8
|
52.4
|
52.8
|
40
|
359
|
1.7
|
47.3
|
47.7
|
48.3
|
50.5
|
52.7
|
53.3
|
53.7
|
41
|
148
|
1.7
|
48.1
|
48.5
|
49.2
|
51.3
|
53.5
|
54.1
|
54.5
|
42
|
30
|
1.8
|
48.7
|
49.2
|
49.8
|
52.1
|
54.4
|
55.1
|
55.55
|
Male
|
28
|
66
|
1.5
|
34.6
|
35.0
|
35.5
|
37.4
|
39.3
|
39.9
|
40.2
|
29
|
69
|
1.5
|
36.0
|
36.3
|
36.9
|
38.8
|
40.7
|
41.2
|
41.6
|
30
|
87
|
1.5
|
37.3
|
37.6
|
38.2
|
40.1
|
42.0
|
42.5
|
42.9
|
31
|
130
|
1.5
|
38.5
|
38.9
|
39.4
|
41.3
|
43.2
|
43.8
|
44.1
|
32
|
152
|
1.5
|
39.7
|
40.1
|
40.6
|
42.5
|
44.5
|
45.0
|
45.4
|
33
|
136
|
1.5
|
40.9
|
41.2
|
41.8
|
43.7
|
45.6
|
46.2
|
46.5
|
34
|
154
|
1.5
|
42.0
|
42.3
|
42.9
|
44.8
|
46.7
|
47.3
|
47.6
|
35
|
123
|
1.5
|
43.1
|
43.4
|
44.0
|
45.9
|
47.8
|
48.3
|
48.7
|
36
|
124
|
1.5
|
44.1
|
44.4
|
45.0
|
46.9
|
48.8
|
49.4
|
49.7
|
37
|
130
|
1.6
|
44.9
|
45.2
|
45.8
|
47.9
|
49.9
|
50.5
|
50.9
|
38
|
178
|
1.7
|
45.66
|
46.0
|
46.6
|
48.8
|
51.0
|
51.6
|
52.0
|
39
|
241
|
1.7
|
46.5
|
46.9
|
47.5
|
49.7
|
51.9
|
52.5
|
52.9
|
40
|
192
|
1.7
|
47.3
|
47.7
|
48.4
|
50.5
|
52.7
|
53.3
|
53.7
|
41
|
75
|
1.7
|
48.1
|
48.5
|
49.1
|
51.3
|
53.5
|
54.1
|
54.5
|
42
|
17
|
1.8
|
48.7
|
49.1
|
49.8
|
52.1
|
54.4
|
55.0
|
55.5
|
Female
|
28
|
42
|
1.5
|
34.5
|
34.9
|
35.4
|
37.3
|
39.2
|
39.8
|
40.1
|
29
|
57
|
1.5
|
35.8
|
36.2
|
36.7
|
38.6
|
40.6
|
41.1
|
41.5
|
30
|
67
|
1.5
|
37.1
|
37.4
|
38.0
|
39.9
|
41.8
|
42.4
|
42.7
|
31
|
79
|
1.5
|
38.3
|
38.7
|
39.2
|
41.1
|
43.1
|
43.6
|
44.0
|
32
|
86
|
1.5
|
39.5
|
39.8
|
40.4
|
42.3
|
44.2
|
44.8
|
45.1
|
33
|
114
|
1.5
|
40.6
|
41.0
|
41.5
|
43.5
|
45.4
|
45.9
|
46.3
|
34
|
130
|
1.5
|
41.7
|
42.1
|
42.6
|
44.6
|
46.5
|
47.0
|
47.4
|
35
|
111
|
1.5
|
42.8
|
43.1
|
43.7
|
45.6
|
47.5
|
48.1
|
48.7
|
36
|
89
|
1.5
|
43.8
|
44.2
|
44.7
|
46.6
|
48.6
|
49.1
|
49.5
|
37
|
97
|
1.6
|
44.6
|
45.0
|
45.6
|
47.6
|
49.7
|
50.2
|
50.6
|
38
|
167
|
1.7
|
45.3
|
45.7
|
46.4
|
48.5
|
50.7
|
51.3
|
51.7
|
39
|
254
|
1.7
|
46.2
|
46.6
|
47.3
|
49.4
|
51.6
|
52.2
|
52.6
|
40
|
167
|
1.7
|
47.1
|
47.5
|
48.1
|
50.3
|
52.5
|
53.1
|
53.5
|
41
|
73
|
1.7
|
47.9
|
48.3
|
48.9
|
51.1
|
53.3
|
53.9
|
54.3
|
42
|
13
|
1.8
|
48.5
|
48.9
|
49.5
|
51.8
|
54.2
|
54.8
|
55.2
|
Table 3.4. Both sexes, male, female birth head circumference Percentiles by GA
GA
|
n
|
SD
|
Percentiles
|
3rd
|
5th
|
10th
|
50th
|
90th
|
95th
|
97th
|
Both sexes
|
28
|
108
|
0.9
|
23.8
|
24.0
|
24.3
|
25.5
|
26.6
|
26.9
|
27.1
|
29
|
126
|
0.9
|
24.7
|
24.9
|
25.3
|
26.4
|
27.6
|
27.9
|
28.1
|
30
|
154
|
0.9
|
25.6
|
25.8
|
26.1
|
27.3
|
28.4
|
28.8
|
29.0
|
31
|
209
|
0.9
|
26.4
|
26.6
|
27.0
|
28.1
|
29.3
|
29.6
|
29.8
|
32
|
238
|
0.9
|
27.2
|
27.4
|
27.8
|
28.9
|
30.1
|
30.4
|
30.6
|
33
|
250
|
1.0
|
27.8
|
28.1
|
28.4
|
29.7
|
31.0
|
31.3
|
31.6
|
34
|
284
|
1.0
|
28.5
|
28.8
|
29.1
|
30.4
|
31.7
|
32.0
|
32.3
|
35
|
234
|
1.0
|
29.2
|
29.4
|
29.8
|
31.1
|
32.4
|
32.7
|
33.0
|
36
|
213
|
1.1
|
29.6
|
29.9
|
30.3
|
31.7
|
33.1
|
33.5
|
33.8
|
37
|
227
|
1.1
|
30.2
|
30.5
|
30.9
|
32.3
|
33.7
|
34.1
|
34.4
|
38
|
345
|
1.1
|
30.8
|
31.1
|
31.5
|
32.9
|
34.3
|
34.7
|
34.9
|
39
|
495
|
1.2
|
31.1
|
31.4
|
31.9
|
33.4
|
34.9
|
35.4
|
35.6
|
40
|
359
|
1.2
|
31.6
|
31.9
|
32.3
|
33.9
|
35.4
|
35.8
|
36.1
|
41
|
148
|
1.2
|
32.1
|
32.3
|
32.8
|
34.3
|
35.8
|
36.3
|
36.6
|
42
|
30
|
1.3
|
32.3
|
32.6
|
33.1
|
34.7
|
36.3
|
36.8
|
37.1
|
Male
|
28
|
66
|
1.07
|
23.9
|
24.2
|
24.6
|
25.9
|
27.3
|
27.7
|
27.9
|
29
|
69
|
1.08
|
24.9
|
25.1
|
25.5
|
26.9
|
28.3
|
28.7
|
28.9
|
30
|
87
|
1.09
|
25.8
|
26.0
|
26.4
|
27.8
|
29.2
|
29.6
|
29.9
|
31
|
130
|
1.1
|
26.6
|
26.9
|
27.3
|
28.7
|
30.1
|
30.5
|
30.8
|
32
|
152
|
1.12
|
27.4
|
27.7
|
28.1
|
29.5
|
31.0
|
31.4
|
31.6
|
33
|
136
|
1.13
|
28.2
|
28.5
|
28.9
|
30.3
|
31.8
|
32.2
|
32.5
|
34
|
154
|
1.14
|
28.9
|
29.2
|
29.6
|
31.1
|
32.6
|
33.0
|
33.2
|
35
|
123
|
1.15
|
29.7
|
29.9
|
30.3
|
31.8
|
33.3
|
33.7
|
34.0
|
36
|
124
|
1.17
|
30.3
|
30.6
|
31.0
|
32.5
|
34.0
|
34.4
|
34.7
|
37
|
130
|
1.18
|
30.9
|
31.2
|
31.6
|
33.1
|
34.6
|
35.1
|
35.4
|
38
|
178
|
1.19
|
31.5
|
31.8
|
32.2
|
33.7
|
35.3
|
35.7
|
36.0
|
39
|
241
|
1.20
|
32.0
|
32.3
|
32.8
|
34.3
|
35.8
|
36.3
|
36.6
|
40
|
192
|
1.21
|
32.5
|
32.8
|
33.3
|
34.8
|
36.4
|
36.8
|
37.1
|
41
|
75
|
1.23
|
33.0
|
33.3
|
33.7
|
35.3
|
36.9
|
37.3
|
37.6
|
42
|
17
|
1.24
|
33.4
|
33.7
|
34.2
|
35.7
|
37.3
|
37.8
|
38.1
|
Female
|
28
|
42
|
1.07
|
23.3
|
23.6
|
24.0
|
25.4
|
26.7
|
27.1
|
27.4
|
29
|
57
|
1.08
|
24.2
|
24.5
|
24.9
|
26.3
|
27.7
|
28.1
|
28.3
|
30
|
67
|
1.09
|
25.1
|
25.4
|
25.8
|
27.2
|
28.6
|
29.0
|
29.3
|
31
|
79
|
1.1
|
25.9
|
26.2
|
26.6
|
28.1
|
29.4
|
29.9
|
30.1
|
32
|
86
|
1.12
|
26.7
|
27.0
|
27.4
|
28.8
|
30.3
|
30.7
|
30.9
|
33
|
114
|
1.13
|
27.4
|
27.7
|
28.2
|
29.6
|
31.1
|
31.5
|
31.7
|
34
|
130
|
1.14
|
28.1
|
28.4
|
28.8
|
30.3
|
31.8
|
32.2
|
32.5
|
35
|
111
|
1.15
|
28.8
|
29.1
|
29.5
|
31.0
|
32.5
|
32.9
|
33.2
|
36
|
89
|
1.17
|
29.4
|
29.7
|
30.1
|
31.6
|
33.1
|
33.5
|
33.8
|
37
|
97
|
1.18
|
29.9
|
30.2
|
30.7
|
32.2
|
33.7
|
34.1
|
34.4
|
38
|
167
|
1.19
|
30.5
|
30.7
|
31.2
|
32.7
|
34.3
|
34.7
|
35.0
|
39
|
254
|
1.20
|
30.9
|
31.2
|
31.7
|
33.2
|
34.8
|
35.2
|
35.5
|
40
|
167
|
1.22
|
31.4
|
31.7
|
32.1
|
33.7
|
35.3
|
35.7
|
35.9
|
41
|
73
|
1.23
|
31.7
|
32.1
|
32.5
|
34.1
|
35.7
|
36.1
|
36.4
|
42
|
13
|
1.24
|
32.1
|
32.4
|
32.8
|
34.4
|
36.0
|
36.5
|
36.8
|
Base on the above tables, the charts below were drawn:
 
Chart 3.4, 3.5. Percentiles curves for birth lenght and head circumference
from 28-42 weeks by gestaional age: Both sexes, male.
Chart 3.6. Percentiles curves for birth lenght and head circumference
from 28-42 weeks by gestaional age: female
3.1.3. Birth Ponderal Index:
Ponderal index (PI) = weight(g)x100/lenght(cm)3
Base on the recipe of calculating pecentiles, we had table and chart as follow:
Table 3.5. Birth ponderal index Percentiles by GA
Week
|
n
|
SD
|
Percentiles
|
3rd
|
5th
|
10th
|
50th
|
90th
|
95th
|
97th
|
28
|
108
|
0.198
|
1.65
|
1.70
|
1.77
|
2.02
|
2.28
|
2.35
|
2.40
|
29
|
126
|
0.205
|
1.71
|
1.76
|
1.83
|
2.10
|
2.36
|
2.43
|
2.48
|
30
|
154
|
0.212
|
1.77
|
1.82
|
1.89
|
2.17
|
2.44
|
2.51
|
2.56
|
31
|
209
|
0.217
|
1.82
|
1.87
|
1.95
|
2.23
|
2.51
|
2.59
|
2.64
|
32
|
238
|
0.222
|
1.87
|
1.93
|
2.01
|
2.29
|
2.58
|
2.66
|
2.71
|
33
|
250
|
0.225
|
1.92
|
1.98
|
2.06
|
2.35
|
2.64
|
2.72
|
2.77
|
34
|
284
|
0.227
|
1.97
|
2.02
|
2.11
|
2.40
|
2.69
|
2.77
|
2.83
|
35
|
234
|
0.229
|
2.01
|
2.07
|
2.15
|
2.44
|
2.74
|
2.82
|
2.87
|
36
|
213
|
0.229
|
2.06
|
2.11
|
2.19
|
2.48
|
2.78
|
2.86
|
2.91
|
37
|
227
|
0.227
|
2.09
|
2.15
|
2.23
|
2.52
|
2.81
|
2.89
|
2.95
|
38
|
345
|
0.225
|
2.13
|
2.18
|
2.26
|
2.55
|
2.84
|
2.92
|
2.97
|
39
|
495
|
0.221
|
2.16
|
2.21
|
2.29
|
2.58
|
2.86
|
2.94
|
2.99
|
40
|
359
|
0.216
|
2.19
|
2.24
|
2.32
|
2.59
|
2.87
|
2.95
|
3.00
|
41
|
148
|
0.210
|
2.21
|
2.26
|
2.34
|
2.60
|
2.88
|
2.95
|
3.00
|
42
|
30
|
0.202
|
2.23
|
2.28
|
2.36
|
2.61
|
2.87
|
2.95
|
2.99
|
Base on the above tables, the charts below were drawn:
Chart 3.7. Percentiles curves for ponderal index
from 28-42 weeks by gestaional age
OBJECTIVE II:
3.2. The Vietnamese birth weight and poderal index percentile cut- off in defining fetal small or large for GA
3.2.1. The Vietnamese birth weight cut- off in defining fetal small for GA (called IUGR by Luchenco)
62 babies at the GA of 33 week of healthy mothers and 62 the same babies of mothers suffered from severe pre-exclampsia (those babies have birth weight below the mean level. The babies were weighted and measured, monitored the complications as axphyxia, respiratory distress, hypoglycemia, hypocancicemia, neonatal infection... during 28 days after delivery. Of 62 normal mothers, 9 babies had complication. The number of those babies of pre- exclampsia mothers was 31. So the total number of babies who suffered from one of complication related to IUGR was 40.
Table 3.6. Sensitivity and specificity correspond to birth weight cut-off to diagnosis complication related to IUGR at the 33 week of GA
Birth weight (g)
|
Sensitivity
|
S pecificity
|
≤ 1550
|
65,0
|
9 2,9
|
≤ 1600
|
80,0
|
89,9
|
≤ 1650
|
87,5
|
80
|
≤ 1700
|
90
|
69
|
≤ 1750
|
92,5
|
6
Chart 3.8. ROC curve show the birth weight diagnostic value of complication relate to IUGR
1-Specificity
ROC curve
7,9
|
The choosen birth weight cut-off in defining complication relate to IUGR is 1650gr.
Look at table 3.2, 33 week's column, the cut off ≤ 1650gr corresponds to 10th percentile. So the 10th percentile is the birthweight cut off to define the complication relate to IUGR.
3.2.2.The Vietnamese ponderal index percentile cut- off in defining fetal IUGR
124 babies with 33 week of GA above were calculated PI and the number at each week of GA who was normal and abnormal. The sensitivity and specificcity as follow:
Table 3.7. Sensitivity and specificity correspond to birth weight cut-off to diagnosis complication related to IUGR at the 33 week of GA
PI
|
Specificity
|
ROC curve
S pecificity
|
≤ 2.04
|
77.5
|
91.7
|
≤ 2.05
|
80
|
86.9
|
≤ 2.06
|
85
|
85.7
|
≤ 2.07
|
85
|
78.6
|
≤ 2.10
|
85
|
76.2
|
≤ 2.35
|
87.5
|
70.7
|
Chart 3.9. ROC curve show the PI diagnostic value of complication relate to IUGR
1-Specificity
The choosen PI cut-off in defining complication relate to IUGR is 2.06.
Look at table 3.5, 33 week's column, the cut off ≤ 2.06 corresponds to 10th percentile. So the 10th percentile is the birthweight cut off to define the complication relate to IUGR.
3.2.3. The Vietnamese birth weight percentile cut- off in defining fetal large for GA (macrosomia) According to the study subject for second objective, the babies with GA ≥38 and birth weight ≥ 3300g were choosen, Of which 293 babies were normal delivery, 297 babies were born by C. section and 10 babies born by forceps. Of 297 C.section, 69 cases ralated to abnormal labor. addition of 10 cases forceps, we had 79 cases. Table 3.6. Sensitivity and specificity correspond to birth weight cut-off to diagnosis dytocia related to macrosomia
Birth weight (g)
|
Sensitivity
|
S
ROC curve
pecificity
|
3475
|
0.95
|
0.49
|
3550
|
0.90
|
0.69
|
3650
|
0.76
|
0.78
|
3675
|
0.72
|
0.78
|
3725
|
0.55
|
0.85
|
3775
|
0.55
|
0
1-Specificity
.87
|
Biểu đồ 3.10. ROC curve show the birth weight diagnostic value of dystocia related to macrosomia
The choosen birth weight cut-off in defining dytocia related to macrosomia is 3650gr. Look at table 3.2, 40 week's column, the cut off ≥3650gr corresponds to 90th percentile. So the 90th percentile is the birthweight cut off to define the dytocia related to macrosomia
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