Does one size fit all? The case for ethnic-specific standards of fetal growth

Abstract

Background: Birth weight for gestational age is a widely-used proxy for fetal growth. Although the need for different standards for males and females is generally acknowledged, the physiologic vs pathologic nature of ethnic differences in fetal growth is hotly debated and remains unresolved.

Risk of adverse outcomes among infants of immigrant women according to birth-weight curves tailored to maternal world region of origin

“…Our findings are consistent with those of studies involving infants born to women from East and South Asia in British Columbia 24 and Washington State 25 and to low-risk African-American women. 26 The studies showed that, despite their higher rates of small-for-gestational-age infants based on a single standard, these infants did not have a higher risk of adverse outcomes.…”

“…26 The studies showed that, despite their higher rates of small-for-gestational-age infants based on a single standard, these infants did not have a higher risk of adverse outcomes. Whereas previous studies assessed the impact of maternal birthplace or ethnicity on small for gestational age, [24][25][26] we simultaneously evaluated the impact of maternal origin on large for gestational age and on a wide array of outcomes including neonatal death, thus generating a more complete picture.…”

Perinatal and childhood morbidity and mortality in congenital analbuminemia

“…The present case series supports reports of SGA infants. Epidemiological studies have found that the mean birth weight of First Nations infants is higher compared with other ethnicities and, therefore, we may have underestimated the proportion of cases born SGA, because growth percentiles were determined using Fenton growth charts (17). The rate of miscarriage was not elevated; however, there may be an underestimation of the miscarriage rate because the accuracy of the numbers depend on self-reporting, and first trimester miscarriages are often unrecognized.…”

Rising Disparities in Severe Adverse Birth Outcomes Among Haitians in Québec, Canada, 1981–2006

“…Births \ 26 and [ 43 weeks were not considered because no SGA classification was available [21]. Ethnic-specific growth curves were not available [22]. After exclusion of births missing outcome data, the final sample included 2,124,909 cases for analyses of PTB; 2,131,175 for LBW; and 2,114,520 for SGA birth.…”