Which growth charts to use to classify neonates as small-for-gestational age at birth?

Anand, Pratima; Sahoo, Tanushree; Gulla, Krishna Mohan

doi:10.32677/ijch.2019.v06.i12.001

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…They pertain to a healthy pattern of growth. The standard charts show how the neonates ought to grow rather than how they do grow [ 4 ]. INTERGROWTH-21st (IG-21) is a standard growth chart developed based on data obtained from fetuses and neonates (26-32 weeks of gestational age) across eight countries from different regions of the world [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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

Singamala¹,

Subramanian²,

Chitgupikar³

2023

Cureus

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Background and objective Growth charts are important in monitoring the growth of neonates. The growth of Indian fetuses is understood to be different from the Western population due to multiple factors. In this study, we aimed to analyze the utility of the application of various growth charts in evaluating the birth weights of liveborn neonates at a tertiary teaching hospital. Methodology A total of 729 liveborn neonates between 24 to 42 weeks of gestation delivered at the study institute during the study period were included. Birth weights were plotted on three growth charts - Fenton 2013, INTERGROWTH-21st (IG-21), and Kandraju et al. chart - and classified as small for gestational age (SGA), or appropriate for gestational age (AGA), or large for gestational age (LGA) according to the respective centiles and sex. The incidences of SGA and LGA were calculated with respect to various charts and compared. Statistical analysis was done using the McNemar Chi-square test for paired categorical variables. Cohen’s kappa (K) was used to analyze the concordance between the growth charts. A p-value <0.005 was considered statistically significant. Results Among 668 term neonates, the number of neonates classified as SGA was 313 (46.86%), 236 (35.33%), and 219 (32.78%) according to Fenton 2013, IG-21, and Kandraju et al. chart respectively. The difference in incidences of SGA between Fenton 2013 and IG-21 for term neonates was significant (p=0.0001). The difference between incidences of SGA among term neonates according to Fenton 2013 and Kandraju et al. and IG-21 vs. Kandraju et al. was significant (p=0.0001). Among 61 preterm neonates, the number of neonates classified as SGA was 15, 11, and five according to Fenton 2013, IG-21, and Kandraju et al. respectively. There was no statistically significant difference between the three charts. Among 729 neonates, the number of neonates classified as LGA was 10 (1.37%), 22 (3.02%), and 32 (4.39%) according to Fenton 2013, IG-21, and Kandraju, et al. respectively. The difference in incidences of LGA between Fenton 2013 and IG-21 was significant (p=0.0015). The difference in incidences of LGA between Fenton 2013 and Kandraju et al. was significant (p=0.0001). The difference in incidences of LGA between IG-21 and Kandraju et al. was also significant (p=0.0044). Conclusion Fenton 2013, IG-21, and Kandraju et al. growth charts vary significantly in detecting the incidence of SGA and LGA among term neonates. Among term neonates, IG-21 and Kandraju et al. growth charts are comparable in terms of the estimation of SGA. The Fenton 2013 growth chart showed a higher incidence of SGA among term neonates. The incidence of LGA was highest according to Kandraju et al. growth chart and least according to Fenton 2013. Among preterm neonates, the incidence of SGA as per birth weight was comparable across the three growth charts.

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Section: Introductionmentioning

confidence: 99%

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

Singamala¹,

Subramanian²,

Chitgupikar³

2023

Cureus

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“…Are the international IOM 2009 guidelines for gestational weight gain (GWG) [3], made mainly on Caucasian population, adequate for other population such as Asian women for example? For Indian [4][5][6][7][8], Chinese, Japanese, and Korean scholars, the answer is clearly NO [9][10][11][12]. Especially, as there are relatively few overweight or obese women in these populations, they even argue that the IOM recommendations in contrary are too low for underweight women [9][10][11][12].…”

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confidence: 99%

“…Countries like India, China or Japan have a high rate of lean women [4][5][6][7][8][9][10][11][12][13]. In our formula [1,2], lean women of 18.5 kg/m² should have an optGWG of 20 kg (instead of 12.5-18 kg, IOM 2009 recommendations).…”

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It is Possible to Establish Quickly a Smart-phone Calculator for Optimal Gestational Weight Gain Specific for Indian Pregnant Women

Robillard¹

2022

Act Sci wom hea

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International IOM 2009 recommendations for gestational weight gain during pregnancy are highly contested in Asia by Indians and East-Asian scholars (China, Korea, Japan etc..). They even use "Asian adapted" overweight and obese classifications (e.g. obesity ≥ 27.5 kg/m² instead of 30 kg/m²).We have demonstrated 4 years ago that if we chose as perequisite rationale that the maternal optimal gestational weight in term pregnancies (optGWG) is to have Appropriate for Gestational Age (AGA) term newborns (by definition 80% of a neonatal population, with 10% of SGA -small for gestational age-as well as 10% of LGA -Large for gestational age-), there is an association with maternal PRE-pregnancy Body Mass Index (ppBMI), and that this association is a linear curve (y= ax+b).We propose then an alternative solution for Indian scientists/epidemiologists to confirm in the Indian population our preceding findings and establish in India their specific linear equation knowing the specific SGA-LGA definitions of term newborns in India.It will be easy to make this linear equation accessible everywhere on smartphones for health workers and women themselves. The Indian calculator will give therefore indispensable councils since the beginning of pregnancy to each pregnant woman, and should be useful also for the great "Indian diaspora" around the planet (e.g. Mauritius, Trinidad and Tobago, Fiji, French overseas territories etc…), where obesity is a huge rising problem in this community.

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Which growth charts to use to classify neonates as small-for-gestational age at birth?

Cited by 2 publications

References 20 publications

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

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

It is Possible to Establish Quickly a Smart-phone Calculator for Optimal Gestational Weight Gain Specific for Indian Pregnant Women

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