Comparison of updated birth weight, length and head circumference charts by gestational age in China with the INTERGROWTH-21st NCSS charts: a population-based study

Zhang, Yaqin; Li, Hui; Zong, Xin-Nan; Wu, Hua-Hong

doi:10.1007/s12519-022-00631-4

Cited by 7 publications

(4 citation statements)

References 33 publications

(48 reference statements)

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“…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.…”

Section: Discussionmentioning

confidence: 92%

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

et al. 2023

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IntroductionThere is no global consensus as to which standards are the most appropriate for the assessment of birth weight and length. The study aimed to compare the applicability of regional and global standards to the Lithuanian newborn population by sex and gestational age, based on the prevalence of small or large for gestational age (SGA/LGA).Materials and MethodsAnalysis was performed on neonatal length and weight data obtained from the Lithuanian Medical Birth Register from 1995 to 2015 (618,235 newborns of 24–42 gestational weeks). Their distributions by gestation and sex were estimated using generalized additive models for location, scale, and shape (GAMLSS), and the results were compared with the INTERGROWTH-21st (IG-21) standard to evaluate the prevalence of SGA/LGA (10th/90th centile) at different gestational ages.ResultsThe difference in median length at term between the local reference and IG-21 was 3 cm–4 cm, while median weight at term differed by 200 g. The Lithuanian median weight at term was higher than in IG-21 by a full centile channel width, while the median length at term was higher by two channel widths. Based on the regional reference, the prevalence rates of SGA/LGA were 9.7%/10.1% for boys and 10.1%/9.9% for girls, close to the nominal 10%. Conversely, based on IG-21, the prevalence of SGA in boys/girls was less than half (4.1%/4.4%), while the prevalence of LGA was double (20.7%/19.1%).DiscussionRegional population-based neonatal references represent Lithuanian neonatal weight and length much more accurately than the global standard IG-21 which provides the prevalence rates for SGA/LGA that differ from the true values by a factor of two.

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Section: Discussionmentioning

confidence: 92%

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

et al. 2023

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“…Recently, a retrospective cohort study discovered that the postnatal growth of preterm infants in Shandong province (northern China) was considerably higher than that of the IG-21 growth standards at 40–64 weeks ( 13 ). Zhang et al ( 14 ) also investigated 24,375 infants from 13 cities in China and noticed an inconsistency between the updated Chinese birth size charts and the IG-21 references. However, the domestic data by now are still insufficient to determine whether the IG-21 curves can replace Fenton as an evaluation instrument for premature infants in China.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intergrowth-21st and Fenton growth standards to evaluate and predict the postnatal growth in eastern Chinese preterm infants

Lan,

Fu,

Zhang

et al. 2023

Front. Pediatr.

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ObjectivesThe aim of this article was to compare the differences between Intergrowth-21st (IG-21) and Fenton growth standards in the classification of intrauterine and extrauterine growth restriction (EUGR) in eastern Chinese preterm infants, and detect which one can better relate to neonatal diseases and predict the physical growth outcomes at 3–5 years old.MethodsPremature infants admitted to a tertiary pediatric hospital in Shanghai, China, from 2016 to 2018 were enrolled. Prenatal information, neonatal diseases during hospitalization, and anthropometric data (weight, height, and head circumference) at birth and at discharge were collected and analyzed. Physical growth outcomes (short stature, thinness, and overweight) were examined by telephone investigations in 2021 at age 3–5 years.ResultsThe medium gestational age and birth weight of the included 1,065 preterm newborns were 33.6 weeks and 1,900 g, respectively. The IG-21 curves diagnosed more newborns with small for gestational age (SGA) (19% vs. 14.7%) and fewer newborns with longitudinal EUGR on height (25.5% vs. 27.9%) and head circumference (17.9% vs. 24.7%) compared to Fenton curves. Concordances between Fenton and IG-21 standards were substantial or almost perfect in the classification of SGA and longitudinal EUGR, but minor in cross-sectional EUGR. EUGR identified by Fenton curves was better related to neonatal diseases than IG-21 curves. There were no statistical significances in the prediction of short stature, thinness, and overweight at 3–5 years old between the two charts.ConclusionsIG-21 growth standards are not superior to Fenton in assessing preterm growth and development in the eastern Chinese population.

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“…For instance, in urban districts in Beijing, the percentage of LBW fluctuated around 4.0% [ 22 ], and the estimated rate of LBW and PTB in the Guangdong province was 4.14% and 4.16%, respectively [ 23 ]. The prevalence of SGA was 10.1% in 13 developed cities in China [ 24 ]. Our findings also indicate a significantly rising trend of LBW and PTB, and a declining trend of SGA, which is consistent with previous studies [ 8 , 13 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, advanced maternal age was associated with lower rates of SGA in this study, while prior studies have reported conflicting results [ 18 , 46 ]. The debatable association could be attributed to several reasons: (1) Classifying SGA by various fetal growth curves or birth weight percentiles would lead to differences in the prevalence of SGA [ 24 ]. The birth weight percentiles based on healthy populations, could be more effective for recognizing neonates with intrauterine growth restriction or infant mortality [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis

Zhou¹,

Yu²,

Qian³

et al. 2023

BMC Pregnancy Childbirth

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Background Although highly heterogeneous among countries, the incidence rates of low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) have been increasing globally over the past two decades. To better understand the cause of these secular trends, this study aimed to investigate the effects of age, period, and birth cohort on LBW, PTB, and SGA rates in Shanghai. Methods Data from 2,958,695 singleton live births at 24–41 gestational weeks between 2004 and 2020 were obtained for this study. Age-period-cohort models based on Poisson regression were used to evaluate the independent effects of maternal age, delivery period, and maternal birth cohort on the trends in LBW, PTB, and SGA. Results The overall prevalence rates of LBW, PTB, and SGA were 2.9%, 4.7%, and 9.3%, respectively, and significant changes were observed (average annual change: + 10.7‰, + 9.1‰, -11.9‰) from 2004 to 2020. Cohort effect increased steadily, from 1960 (risk ratio [RR] = 0.71, 95% confidence interval [CI]: 0.65–0.78) to 1993 (RR = 0.97, 95% CI: 0.94–1.01) for LBW and from 1960 (RR = 0.69, 95% CI: 0.64–0.75) to 2004 (RR = 1.02, 95% CI: 0.94–1.12) for PTB. A strong cohort effect was found with the highest risk of SGA (RR = 1.82, 95% CI: 1.72–1.93) in 1960 and the lowest risk (RR = 0.57, 95% CI: 0.54–0.61) in 2004, compared with the reference cohort of 1985. There was a “U-shaped” maternal age effect on LBW and PTB and a weak period effect on the three birth outcomes. Conclusions Our findings suggested a significant independent effect of age, period, and birth cohort on the three birth outcomes. The increasing rates of LBW and PTB motivated us to focus on young and advanced pregnant women. Meanwhile, the prevalence of SGA decreased steadily, illustrating the need for further research on the mechanisms underlying these trends.

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Comparison of updated birth weight, length and head circumference charts by gestational age in China with the INTERGROWTH-21st NCSS charts: a population-based study

Cited by 7 publications

References 33 publications

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

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

Comparison of Intergrowth-21st and Fenton growth standards to evaluate and predict the postnatal growth in eastern Chinese preterm infants

Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis

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