Postnatal Prediction of Gestational Age Using Newborn Fetal Hemoglobin Levels

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• 作者：Kumanan Wilson^a ; ^b ; ^c ; ¹ ; Steven Hawken^a ; ^c ; ^d ; ¹ ; Malia S.Q. Murphy^a ; Katherine M. Atkinson^a ; ^e ; Beth K. Potter^d ; Ann Sprague^f ; Mark Walker^a ; ^f ; ^g ; Pranesh Chakraborty^f ; ^h ; ⁱ ; Julian Little^d
• 关键词：Preterm birth ; Gestational age ; Metabolomics ; Newborn screening ; Prediction modelling
• 刊名：EBioMedicine
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：15
• 期：Complete
• 页码：203-209
• 全文大小：590 K
• 卷排序：15

文摘

Mechanisms for postnatal gestational age estimation are required to guide care in low resource settings. Newborn fetal/adult hemoglobin ratio and other non-mass spectrometry derived data can be used to provide precise estimates of gestational age. Hemoglobin derived postnatal gestational age prediction models also performed comparatively well in small for gestational age infants.Three research groups including our own have recently published on the development of postnatal gestational age prediction algorithms derived from newborn screening metabolic profiles. Expanded newborn screening practices relying on tandem mass spectrometry instrumentation are not common place in many low resource settings, thus limiting the utility of such prediction models. Newborn fetal and adult hemoglobin levels are known to vary by gestational age of birth, and may be derived by methods other than mass spectrometry. In this study we used a retrospective cohort study design to develop and validate the precision of postnatal gestational age prediction models derived from fetal and adult hemoglobin levels, and readily available perinatal characteristics obtained from the Better Outcomes Registry & Network and the Newborn Screening of Ontario program. Final models were able to accurately predict postnatal gestational age to within 2 weeks of true gestational age, with excellent precision to discriminate the gestational age of average and small for gestational age infants. We have built upon our existing postnatal gestational age prediction algorithm to demonstrate both the stand-alone and additive predictive potential of newborn hemoglobin levels to the model. Methods to predict gestational age based on newborn screening markers have the potential to provide accurate postnatal assessments of gestational age in settings where gold standard first trimester ultrasounds are limited.