Customized <i>vs</i> population‐based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta‐analysis of observational studies

Chiossi, Giuseppe; Pedroza, Claudia; Costantine, Maged M.; Truong, Van Thi Thanh; Gargano, Giancarlo; Saade, George R.

doi:10.1002/uog.17381

Cited by 70 publications

(61 citation statements)

References 58 publications

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“…Other ranges include those reported by the Intergrowth-21st Project, 17 which reports data on patients selected based on carefully specified characteristics and customized growth charts, these charts have not been shown to be superior to standardized growth charts. 18 Although we demonstrate a strong correlation between the unadjusted EFW and the BW, the EFW at scan was greater than of USS, if we assume that USS biometry leads to over-measurement as often as it leads to under-measurement, this cannot, on its own, explain the distribution of the differences between BW and EFW shown in Figure 5. A decline in growth velocity in fetal growth restriction and a loss of fetal weight following fetal demise are well reported phenomena [19][20][21] but no previous study has suggested that compromised live fetuses may lose weight in utero.…”

Section: Discussionmentioning

confidence: 53%

“…In this study, we used standard WHO reference values for BW; these are based on multinational data and therefore likely to be applicable to our mixed ethnic population and are standard birth percentile charts used for a UK population and are used for routine clinical care in all UK centers. Other ranges include those reported by the Intergrowth‐21st Project, which reports data on patients selected based on carefully specified characteristics and customized growth charts, these charts have not been shown to be superior to standardized growth charts …”

Section: Discussionmentioning

confidence: 99%

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Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Stephens

Al‐Memar

Beattie-Jones

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Small‐for‐gestational‐age (SGA) confers a higher perinatal risk of adverse outcomes. Birthweight cannot be accurately measured until delivery, therefore accurate estimated fetal weight (EFW) based on ultrasonography is important in identifying this high‐risk population. We aimed to establish the sensitivity of detecting SGA infants antenatally in a unit with a selective third‐trimester ultrasound policy and to investigate the association between EFW and birthweight in these babies. Material and methods A retrospective cohort study was conducted on non‐anomalous singleton pregnancies delivered after 36 weeks of gestation where SGA (<10th percentile) was diagnosed at delivery. The EFW at the time of the third‐trimester ultrasound scan was recorded using standard Hadlock formulae. Results In 2017, there were 8392 non‐anomalous singleton pregnancies live born after 36 weeks, excluding late bookers. 797 were live‐born SGA <10th percentile for birthweight and 464 <5th percentile, who met our inclusion criteria. The antenatal detection rate of SGA was 19.6% for babies with birthweight <10th percentile and 24.1% <5th percentile. There was a significant correlation between the EFW and birthweight of fetuses undergoing ultrasound assessment within 2 weeks of delivery (P < .001, r = 0.73 (Pearson correlation). For these cases, EFW was greater than the birthweight in 65% of cases. After adjusting all EFWs using the discrepancy between EFW and actual birthweight for those babies born within 48 hours of the scan, the mean difference between the birthweight and adjusted EFW 7 days before delivery was 111 g (95% CI 87‐136 g) and at 14 days was 200 g (95% CI 153‐248 g). Despite adjusting the EFW, 61/213 cases (28.6%) apparently lost weight between the ultrasound scan and delivery. Conclusions Small‐for‐gestational‐age infants with a birthweight <10th percentile are poorly identified antenatally with little improvement for those <5th percentile. In SGA babies, ultrasound EFW overestimated birthweight. Discrepancies between birthweight and EFW are not explicable only by the limitations of third‐trimester sonography, a reduction in fetal weight close to delivery in a proportion of liveborn SGA babies is plausible.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Stephens

Al‐Memar

Beattie-Jones

et al. 2019

Acta Obstet Gynecol Scand

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“…129 Consequently, customized percentiles based on maternal characteristics are not recommended. 130,131 Some argue that growth restriction and SGA are not synonymous. 127,132 We use the term FGR in light of the ongoing challenge to discern pathologically from constitutionally small newborns 3, 133, 134 and because we prefer to avoid the impression that we used a cutoff of the lowest decile (which would define SGA).…”

Section: Methodologic Issuesmentioning

confidence: 99%

Neurodevelopment at Age 10 Years of Children Born <28 Weeks With Fetal Growth Restriction

Korzeniewski

Allred

Joseph³

et al. 2017

Pediatrics

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“…However, previous comparisons between customized and population-based growth charts for the detection of fetuses at risk for adverse outcome yielded conflicting results 10, 53, 54, 57-70 . A recent meta-analysis 71 reported that the odds ratios of the association between adverse pregnancy outcomes (e.g. perinatal mortality and neonatal intensive care unit admission) and abnormal birthweight were higher for the customized GROW standard compared to the non-customized standards, although the difference was not statistically significant.…”

Section: Commentmentioning

confidence: 97%

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

Tarca

Romero

Gudicha

et al. 2018

American Journal of Obstetrics and Gynecology

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Background The assessment of fetal growth disorders requires a standard. Current nomograms for the assessment of fetal growth in African American women have been derived either from neonatal (rather than fetal) biometry data or have not been customized for maternal ethnicity, weight, height, parity, and fetal sex. Objective We sought to 1) develop a new customized fetal growth standard for African American mothers; and 2) compare such a standard to three existing standards for the classification of fetuses as small (SGA) or large (LGA) for gestational age. Study Design A retrospective cohort study included 4,183 women (4,001 African American and 182 Caucasian) from the Detroit metropolitan area who underwent ultrasound examinations between 14 and 40 weeks of gestation (the median number of scans per pregnancy was 5, interquartile range 3-7) and for whom relevant covariate data were available. Longitudinal quantile regression was used to build models defining the “normal” estimated fetal weight (EFW) centiles for gestational age in African American women, adjusted for maternal height, weight, parity, and fetal sex, and excluding pathologic factors with a significant effect on fetal weight. The resulting Perinatology Research Branch/Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, PRB/NICHD) growth standard was compared to 3 other existing standards—the customized gestation-related optimal weight (GROW) standard; the Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, NICHD) African American standard; and the multinational World Health Organization (WHO) standard—utilized to screen fetuses for SGA (<10th centile) or LGA (>90th centile) based on the last available ultrasound examination for each pregnancy. Results 1) First, the mean birthweight at 40 weeks was 133g higher for neonates born to Caucasian than to African American mothers and 150g higher for male than female neonates; maternal weight, height, and parity had a positive effect on birthweight.Second, analysis of longitudinal EFW revealed the following features of fetal growth: (1) all weight centiles were about 2% higher for male than for female fetuses; (2) maternal height had a positive effect on EFW, with larger fetuses being affected more (2% increase in the 95th centile of weight for each 10-cm increase in height); and (3) maternal weight and parity had a positive effect on EFW that increased with gestation and varied among the weight centiles. Third, the screen-positive rate for SGA was 7.2% for the NICHD African American standard, 12.3% for the GROW standard, 13% for the WHO standard customized by fetal sex, and 14.4% for the PRB/NICHD customized standard. For all standards, the screen-positive rate for SGA was at least two-fold higher among fetuses delivered preterm than at term.Fourth, the screen-positive rate for LGA was 8.7% for the GROW standard, 9.2% for the PRB/NICHD customized standard, 10.8% for the WHO standard customized by fetal sex, and 12.3% ...

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Customized vs population‐based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta‐analysis of observational studies

Cited by 70 publications

References 58 publications

Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Neurodevelopment at Age 10 Years of Children Born <28 Weeks With Fetal Growth Restriction

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

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Customized vs population‐based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta‐analysis of observational studies

Cited by 70 publications

References 58 publications

Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Comparing the relation between ultrasound‐estimated fetal weight and birthweight in cohort of small‐for‐gestational‐age fetuses

Neurodevelopment at Age 10 Years of Children Born &lt;28 Weeks With Fetal Growth Restriction

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

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Neurodevelopment at Age 10 Years of Children Born <28 Weeks With Fetal Growth Restriction