Comparison of application of Fenton, Intergrowth-21st and WHO growth charts in a population of Polish newborns

Abstract

Background: Growth charts are the primary tools for evaluating neonatal birth weight and length. They help and qualify the neonates as Appropriate for Gestational Age (AGA), Small for Gestational Age (SGA), or Large for Gestational Age (LGA). The most commonly used neonatal charts include Intergrowth-21st, WHO, and Fenton. The aim of the study was to compare the tools used for assessing neonatal birth weight and the incidence of SGA and LGA using the different charts. Methods: Data on 8608 births in the Clinical Department of Obstetrics and Gynecology were compared. We divided the patient population into five gestational age groups. The 10th and 90th percentiles were calculated. The percentage of cases meeting the SGA and LGA criteria was determined. Results: Statistically significant differences between growth charts were identified for each of the groups. The 10th percentile for the study population corresponded to 2970 g for females and 3060 g for males born in the 40th week of gestation. The 90th percentile values were 4030 g and 4120 g. Our analysis showed a statistically significant difference in detection of LGA or SGA between three growth charts and our data both in male (χ 2 (3) = 157.192, p < 0.001, Kramer's V = 0.444) and female newborns (χ 2 (3) = 162.660, p < 0.001, Kramer's V = 0.464). Discussion: Our results confirm that differences exist between growth charts. There is a need for harmonizing growth assessment standards. It is recommended that a growth chart should be developed for the Polish population, which would improve the diagnosis of SGA and LGA.

A Cross-Sectional Study Comparing the Efficacy of Various Growth Charts in Evaluating the Incidences of Small for Gestational Age and Large for Gestational Age at Birth Among Liveborn Neonates Delivered at a Tertiary Teaching Hospital

“…The study observed that the difference in incidences of SGA between IG-21 and Fenton 2013 and between IG-21 and Alexander et al charts was significant with a p-value <0.001 for both comparisons and K of 0.5625 and 0.5581 respectively. Similarly, Jakubowski et al [ 18 ] observed significant differences between Fenton, IG-21, and WHO growth charts for the detection of SGA and LGA among 8,608 neonates from Poland, across 24-40 weeks of gestational age.…”

“…The study observed that the difference in incidences of SGA between IG-21 and Fenton 2013 and between IG-21 and Alexander et al charts was significant with a pvalue <0.001 for both comparisons and K of 0.5625 and 0.5581 respectively. Similarly, Jakubowski et al[18] observed significant differences between Fenton, IG-21, and WHO growth charts for the detection of SGA and LGA among 8,608 neonates from Poland, across 24-40 weeks of gestational age.Among the 61 preterm neonates in this study, only four neonates who were classified as SGA according to the Fenton 2013 growth chart were classified as AGA according to the IG-21 growth chart. The difference between incidences of SGA according to Fenton 2013 and IG-21 was not significant.…”

Regional references vs. international standards for assessing weight and length by gestational age in Lithuanian neonates

“…Noteworthy, our previous study comparing the Lithuanian neonatal head circumference reference with the IG-21 showed similar concerning results for term newborns (31). Likewise, other studies from different continents also found their regional neonatal reference charts to be significantly different from the neonatal standards provided by the IG-21 (24,29,(32)(33)(34)(35). In spite of the fact that the IG-21 found some support (36, 37), an increasing number of studies consider the IG-21 with caution including the findings of our study that support this position.…”

“…The possibility to evaluate the prevalence of SGA/LGA newborns at all gestational weeks may be considered a major strength of our study. While there are studies examining the newborn size categorization at term period depending on the tools used ( 2 , 33 , 38 ), less of them are focused on the SGA/LGA prevalence in different gestations ( 39 ). This is of a particular interest in terms of a deeper understanding of biological processes during the fetal development.…”