Adjustment of birth weight standards for maternal and infant characteristics improves the prediction of outcome in the small-for-gestational-age infant

Sciscione,; Gorman,; Callan,

doi:10.1053/ob.1996.v175.a73600

Cited by 40 publications

(22 citation statements)

References 7 publications

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“…This could have introduced bias into our study population. However, the consistency between the results of our study and earlier studies 3,4,6 suggests that any bias that may exist is not substantial.…”

Section: Customised Birthweight Centiles Predict Perinatal Morbidity supporting

confidence: 80%

“…These data are consistent with the findings of others and suggest that customised birthweight centiles perform better than population centiles in identifying small babies with perinatal deaths. 3,6 After application of customised centiles 25% of population SGA babies in the general population were reclassified as appropriately grown ('population SGA only'). We found that mothers of these babies were shorter, lighter, had lower body mass indices and were more likely to be nulliparous than women whose babies were SGA by both customised and population criteria.…”

Section: Customised Birthweight Centiles Predict Perinatal Morbidity mentioning

confidence: 99%

“…3,6 The first study, conducted in the United States, reported that serious neonatal morbidity and perinatal mortality were more common in babies classified as SGA after adjusting for maternal age, size and black versus white ethnicity compared with those who were classified as SGA by population centiles. In the second study carried out in Sweden, low five-minute Apgar scores and perinatal deaths were more common in babies SGA by customised compared with population centiles.…”

Section: Introductionmentioning

confidence: 99%

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Customised birthweight centiles predict SGA pregnancies with perinatal morbidity

McCowan

Harding

Stewart

2005

BJOG

195

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Objectives To determine the following: (1) the proportion of babies reclassified as small or appropriately grown using customised and population centiles; and (2) the relative risks of perinatal morbidity, including abnormal umbilical Doppler studies, in babies classified as small for gestational age (SGA) and appropriate for gestational age (non‐SGA) using the two centile calculations. Design Cohort study in SGA and general hospital populations. Setting National Women's Hospital, Auckland, NZ. Population A cohort of SGA pregnancies (n= 374) and a general obstetric population (n= 12,879). Methods Pregnancy outcomes were compared between ‘non‐SGA both’ (≥10th% by population and customised centiles) and those who were ‘SGA both’ (<10th% by population and customised centiles), ‘SGA customised only’ (SGA by customised but non‐SGA by population centiles) and ‘SGA population only’ (SGA by population but non‐SGA by customised centiles). Main outcome measures Maternal and newborn morbidity and perinatal death. Results In the SGA cohort 271 (72%) babies were ‘SGA both’, 27 (7%) were ‘SGA customised only’, 32 (9%) were ‘population SGA only’ and 44 (12%) were ‘non‐SGA both’. In the general obstetric population 863 (6.7%) babies were ‘SGA both’, 445 (3.5%) were ‘customised SGA only’, 285 (2.2%) were ‘population SGA only’ and 11,286 (88%) were ‘non‐SGA both’. Perinatal death and newborn morbidity including nursery admission and long hospital stay were increased and comparable between ‘SGA both’ and ‘customised SGA only’ in both study populations. Newborn morbidity was low and comparable between ‘population SGA only’ and ‘non‐SGA both’. No perinatal deaths occurred in ‘population SGA only’ babies. Abnormal Doppler studies were more common in ‘SGA both’ or ‘customised SGA only’ but not in ‘population SGA only’ groups compared with ‘non‐SGA both’. Conclusions Customised birthweight centiles identified small babies at risk of morbidity and mortality. Use of customised centiles is likely to detect more babies at risk of perinatal morbidity and mortality than would be detected by population centiles.

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Section: Customised Birthweight Centiles Predict Perinatal Morbidity supporting

confidence: 80%

Section: Customised Birthweight Centiles Predict Perinatal Morbidity mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Customised birthweight centiles predict SGA pregnancies with perinatal morbidity

McCowan

Harding

Stewart

2005

BJOG

195

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“…54,55 in addition, customized growth percentiles are better correlated with adverse pregnancy events and reduce the frequency of additional testing because of false-positive screening information. [56][57][58] ultrasound assessment, using uterine artery doppler and placental morphology, is of value to distinguish a subset of pregnancies at high risk of early severe FGR. [59][60][61] In women with risk factors for intrauterine growth restriction, uterine artery doppler screening at 19 to 23 weeks may identify pregnancies at risk of antepartum stillbirth and preterm delivery due to intrauterine growth restriction and placental disease.…”

Section: Screening and Diagnosismentioning

confidence: 99%

Fetal growth restriction: aetiology, screening, diagnosis and management

Augusthy

2015

Int J Reprod Contracept Obstet Gynecol

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Foetal growth restriction (FGR) is a pathological condition that refers to a foetus that fails to reach his/her genetically predetermined growth potential. FGR remains a leading contributor to perinatal mortality and morbidity and metabolic syndrome in later life. The purpose of this review is to provide the summary statements of the aetiology of FGR and to establish a framework for screening, diagnosis, and management of pregnancies affected with foetal growth restriction. For this study, published literature was retrieved through searches of PubMed (Medline), Highwire, Google Scholar, Scopus, Cochrane Database of Systematic Reviews. Conference/Seminar proceedings, textbooks, previously published systematic reviews, controlled clinical trials, high quality prospective and retrospective observational studies, research articles and unpublished studies were also used for this study. The identification of FGR begins with assessment of maternal, foetal, placental and environmental risk factors and the diagnosis is made by Ultrasound biometry examination. Functional assessment of placental and foetal circulation by Doppler velocimetry and blood flow volume, together with computerized assessment of foetal heart rate variability, are key examinations in early and late FGR to assess severity of the disease and monitor foetal wellbeing. Appropriate timing of delivery in early FGR might change the outcome, and appropriate monitoring in late and term FGR might avoid unnecessary interventions.

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“…43 Individually adjusted or customized growth charts aim to optimize the assessment of fetal growth by taking individual variation into account, and by projecting an optimal curve which delineates the potential weight gain in each pregnancy. The use of customised birthweight standards, which take these factors into account, has demonstrated to improve the definition of SGA and the prediction of abnormal 5-minute Apgar score, hospital stay length, admission to the intensive care unit, hypoglycemia, need for neonatal resuscitation and perinatal death, both in highrisk 44 and low-risk [45][46][47][48] populations. On the other hand, those neonates with a normal customized birthweight have been found to have a perinatal outcome comparable to the general population, regardless of being SGA according populationbased centiles.…”

Section: Assessing Growthmentioning

confidence: 99%