The World Health Organization fetal growth charts: concept, findings, interpretation, and application

Kiserud, Torvid; Benachi, Alexandra; Hecher, Kurt; Perez, Rogelio González; Carvalho, José Ferreira de; Piaggio, Gilda; Platt, Lawrence D.

doi:10.1016/j.ajog.2017.12.010

Cited by 187 publications

(147 citation statements)

References 52 publications

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“…For the WHO fetal growth standard, EFW was calculated based on the three‐parameter Hadlock formula (HC, AC and FL) and was compared with the reference charts without customization for fetal sex.…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, recent initiatives to develop growth standards did not implement customization of growth charts, or they customized only for a subset of non‐pathologic factors known to affect fetal growth. For example, the World Health Organization (WHO) growth standard customizes only by fetal sex, while the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) developed ethnicity‐specific charts without adjusting for other factors. In addition, the INTERGROWTH‐21 st project proposed a ‘one‐size‐fits‐all’ standard without customization, yet the decision not to adjust for fetal sex was based on ethical grounds.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population‐based standards

Kabiri

Romero²,

Gudicha

et al. 2020

Ultrasound in Obstet & Gyne

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Objective To compare the predictive performance of estimated fetal weight (EFW) percentiles, according to eight growth standards, to detect fetuses at risk for adverse perinatal outcome. Methods This was a retrospective cohort study of 3437 African‐American women. Population‐based (Hadlock, INTERGROWTH‐21st, World Health Organization (WHO), Fetal Medicine Foundation (FMF)), ethnicity‐specific (Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)), customized (Gestation‐Related Optimal Weight (GROW)) and African‐American customized (Perinatology Research Branch (PRB)/NICHD) growth standards were used to calculate EFW percentiles from the last available scan prior to delivery. Prediction performance indices and relative risk (RR) were calculated for EFW < 10th and > 90th percentiles, according to each standard, for individual and composite adverse perinatal outcomes. Sensitivity at a fixed (10%) false‐positive rate (FPR) and partial (FPR < 10%) and full areas under the receiver‐operating‐characteristics curves (AUC) were compared between the standards. Results Ten percent (341/3437) of neonates were classified as small‐for‐gestational age (SGA) at birth, and of these 16.4% (56/341) had at least one adverse perinatal outcome. SGA neonates had a 1.5‐fold increased risk of any adverse perinatal outcome (P < 0.05). The screen‐positive rate of EFW < 10th percentile varied from 6.8% (NICHD) to 24.4% (FMF). EFW < 10th percentile, according to all standards, was associated with an increased risk for each of the adverse perinatal outcomes considered (P < 0.05 for all). The highest RRs associated with EFW < 10th percentile for each adverse outcome were 5.1 (95% CI, 2.1–12.3) for perinatal mortality (WHO); 5.0 (95% CI, 3.2–7.8) for perinatal hypoglycemia (NICHD); 3.4 (95% CI, 2.4–4.7) for mechanical ventilation (NICHD); 2.9 (95% CI, 1.8–4.6) for 5‐min Apgar score < 7 (GROW); 2.7 (95% CI, 2.0–3.6) for neonatal intensive care unit (NICU) admission (NICHD); and 2.5 (95% CI, 1.9–3.1) for composite adverse perinatal outcome (NICHD). Although the RR CIs overlapped among all standards for each individual outcome, the RR of composite adverse perinatal outcome in pregnancies with EFW < 10th percentile was higher according to the NICHD (2.46; 95% CI, 1.9–3.1) than the FMF (1.47; 95% CI, 1.2–1.8) standard. The sensitivity for composite adverse perinatal outcome varied substantially between standards, ranging from 15% for NICHD to 32% for FMF, due mostly to differences in FPR; this variation subsided when the FPR was set to the same value (10%). Analysis of AUC revealed significantly better performance for the prediction of perinatal mortality by the PRB/NICHD standard (AUC = 0.70) compared with the Hadlock (AUC = 0.66) and FMF (AUC = 0.64) standards. Evaluation of partial AUC (FPR < 10%) demonstrated that the INTERGROWTH‐21st standard performed better than the Hadlock standard for the prediction of NICU admission and mechanical ventilation (P < 0.05 for both). Although fetuses with EFW > 90t...

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population‐based standards

Kabiri

Romero²,

Gudicha

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…The WHO fetal size charts (middle right) were derived from an international low-risk population of women who delivered either at term or preterm, under the assumption that, of all factors considered, only fetal sex has a sizable effect on estimated fetal weight (female: continuous lines; male: interrupted lines) 4 . In this study, the authors noted differences in fetal weight depending upon maternal country of origin (ethnic distribution was approximately 20% African, 20% Asian, and 60% Caucasian).…”

Section: World Health Organization (Who)mentioning

confidence: 99%

Fetal size standards to diagnose a small- or a large-for-gestational-age fetus

Romero

Tarca

2018

American Journal of Obstetrics and Gynecology

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“…Birth weight (BW) is the most important index re ecting intrauterine growth and development, and also a vital index to evaluate the health status of the newborn [1]. Abnormal BW, including low birth weight (LBW, BW < 2500 g) and macrosomia (BW ≥ 4000 g), signi cantly increases the risk of perinatal mortality and morbidity [2].…”

Section: Introductionmentioning

confidence: 99%

Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China

Wang

Yang

Shang

et al. 2020

Preprint

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Background: Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight. Methods: Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi’an, China. A total of 490143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, birth date of the newborns, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia. Results: The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age is less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR= 0.917, 95%CI: 0.903, 0.932 when maternal age younger than 27 years old; OR= 0.965, 95%CI: 0.955, 0.976 when maternal age ranging from 27 to 36 years old), then increased when maternal age older than 36 years old (OR=1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR=1.102, 95%CI: 1.075, 1.129 when maternal age younger than 24 years old; OR=1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR=1.029, 95%CI: 1.012, 1.046 when maternal age older than 33 years old). Conclusions: For women of childbearing age (20-40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.

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The World Health Organization fetal growth charts: concept, findings, interpretation, and application

Cited by 187 publications

References 52 publications

Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population‐based standards

Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and population‐based standards

Fetal size standards to diagnose a small- or a large-for-gestational-age fetus

Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China

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