BackgroundPreterm infants are a group at high risk of having experienced placental insufficiency. It is unclear which growth charts perform best in identifying infants at increased risk of stillbirth and other adverse perinatal outcomes. We compared 2 birthweight charts (population centiles and INTERGROWTH-21st birthweight centiles) and 3 fetal growth charts (INTERGROWTH-21st fetal growth charts, World Health Organization fetal growth charts, and Gestation Related Optimal Weight [GROW] customised growth charts) to identify which chart performed best in identifying infants at increased risk of adverse perinatal outcome in a preterm population.Methods and findingsWe conducted a retrospective cohort study of all preterm infants born at 24.0 to 36.9 weeks gestation in Victoria, Australia, from 2005 to 2015 (28,968 records available for analysis). All above growth charts were applied to the population. Proportions classified as <5th centile and <10th centile by each chart were compared, as were proportions of stillborn infants considered small for gestational age (SGA, <10th centile) by each chart. We then compared the relative performance of non-overlapping SGA cohorts by each chart to our low-risk reference population (infants born appropriate size for gestational age [>10th and <90th centile] by all intrauterine charts [AGAall]) for the following perinatal outcomes: stillbirth, perinatal mortality (stillbirth or neonatal death), Apgar <4 or <7 at 5 minutes, neonatal intensive care unit admissions, suspicion of poor fetal growth leading to expedited delivery, and cesarean section. All intrauterine charts classified a greater proportion of infants as <5th or <10th centile than birthweight charts. The magnitude of the difference between birthweight and fetal charts was greater at more preterm gestations. Of the fetal charts, GROW customised charts classified the greatest number of infants as SGA (22.3%) and the greatest number of stillborn infants as SGA (57%). INTERGROWTH classified almost no additional infants as SGA that were not already considered SGA on GROW or WHO charts; however, those infants classified as SGA by INTERGROWTH had the greatest risk of both stillbirth and total perinatal mortality. GROW customised charts classified a larger proportion of infants as SGA, and these infants were still at increased risk of mortality and adverse perinatal outcomes compared to the AGAall population. Consistent with similar studies in this field, our study was limited in comparing growth charts by the degree of overlap, with many infants classified as SGA by multiple charts. We attempted to overcome this by examining and comparing sub-populations classified as SGA by only 1 growth chart.ConclusionsIn this study, fetal charts classified greater proportions of preterm and stillborn infants as SGA, which more accurately reflected true fetal growth restriction. Of the intrauterine charts, INTERGROWTH classified the smallest number of preterm infants as SGA, although it identified a particularly high-risk cohort, and GROW cus...

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We provide data preprocessing, additional simulations, and detailed technical proofs along with supporting lemmas for our quantile penalized generalized estimating equations approach for longitudinal data in ultra-high dimensions. In Section A, we discuss the data preprocessing for the Framingham data. In Section B, we provide a sketch of the proof for the challenging theorems established in the main paper. In Section C, we show detailed proofs for all propositions for the unpenalized oracle estimator. In Section D, we provide proofs of Theorems 1 and 2 for the quantile penalized GEE estimators in ultra-high dimensions. In Section E, we present proofs of model-selection consistency for high-dimensional BIC. Finally, in Section F, we conduct additional simulations under unbalanced design and illustrate the advantages of the proposed approach incorporating correlated longitudinal data.

Background Stillbirth increases steeply after 42 weeks gestation; hence, induction of labour (IOL) is recommended after 41 weeks. Recent Victorian data demonstrate that term stillbirth risk rises at an earlier gestation in south Asian mothers (SAM). Aims To determine the impact on a non‐tertiary hospital in Melbourne, Australia, if post‐dates IOL were recommended one week earlier at 40 + 3 for SAM; and to calculate the proportion of infants with birthweight < 3rd centile that were undelivered by 40 weeks in SAM and non‐SAM, as these cases may represent undetected fetal growth restriction. Materials and Methods Singleton births ≥ 37 weeks during 2017–18 were extracted from the hospital Birthing Outcomes System. Obstetric and neonatal outcomes for pregnancies that birthed after spontaneous onset of labour or IOL were analysed according to gestation and country of birth. Results There were 5408 births included, and 24.9% were born to SAM (n = 1345). SAM women had a higher rate of IOL ≥ 37 weeks compared with non‐SAM women (42.5% vs 35.0%, P < 0.001). If all SAM accepted an offer of IOL at 40 + 3, there would be an additional 80 term inductions over two years. There was no significant difference in babies < 3rd centile undelivered by 40 weeks in SAM compared with non‐SAM (29.6% vs 37.7%, P = 0.42). Conclusions Earlier IOL for post‐term SAM would only modestly increase the demand on birthing services, due to pre‐existing high rates of IOL. Our current practices appear to capture the majority at highest risk of stillbirth in our SAM population.

At a conference last year, Suzanne Thornton, Brittany Green and Emma Benn organised a panel session to share advice and recommendations for making the statistics and data science community more inclusive and supportive of gender non‐conforming and LGBTQ persons. Here they summarise their discussion in the hope of continuing the conversation