Hassib Narchi1, Alyson Skinner, Bernadette Williams. 1. Department of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. hassibnarchi@hotmail.com
Abstract
OBJECTIVES: Birth weight below the 10th percentile on growth charts based on population norms or small for gestational age (SGA) is associated with adverse perinatal outcome. We compare the association among neonatal mortality, morbidity and SGA as determined by currently used percentiles based on population standards (method A) and customised birth weight percentiles (method B). METHODS: Study of outcomes of SGA neonates from a cohort of 6125 consecutive pregnancies, analysed in function of the method (A or B) used to diagnose SGA. RESULTS: There were 831 SGA infants, 84% were born at term and the majority were of European origin (61.4%). By method A, there was a sixfold decrease in the prevalence of SGA babies (2.3%) compared with method B (13.5%). After correcting for prematurity, SGA infants diagnosed by method B alone (not identified by standard population method) still constituted a high proportion of infants with hypothermia and hypoglycaemia (p < 0.05). CONCLUSION: Customised charts identified six times more SGA infants than standard charts. These infants, considered appropriately grown by standard charts, are at a significantly higher risk of morbidity.
OBJECTIVES: Birth weight below the 10th percentile on growth charts based on population norms or small for gestational age (SGA) is associated with adverse perinatal outcome. We compare the association among neonatal mortality, morbidity and SGA as determined by currently used percentiles based on population standards (method A) and customised birth weight percentiles (method B). METHODS: Study of outcomes of SGA neonates from a cohort of 6125 consecutive pregnancies, analysed in function of the method (A or B) used to diagnose SGA. RESULTS: There were 831 SGA infants, 84% were born at term and the majority were of European origin (61.4%). By method A, there was a sixfold decrease in the prevalence of SGA babies (2.3%) compared with method B (13.5%). After correcting for prematurity, SGA infants diagnosed by method B alone (not identified by standard population method) still constituted a high proportion of infants with hypothermia and hypoglycaemia (p < 0.05). CONCLUSION: Customised charts identified six times more SGA infants than standard charts. These infants, considered appropriately grown by standard charts, are at a significantly higher risk of morbidity.
Authors: Joanne Katz; Anne Cc Lee; Naoko Kozuki; Joy E Lawn; Simon Cousens; Hannah Blencowe; Majid Ezzati; Zulfiqar A Bhutta; Tanya Marchant; Barbara A Willey; Linda Adair; Fernando Barros; Abdullah H Baqui; Parul Christian; Wafaie Fawzi; Rogelio Gonzalez; Jean Humphrey; Lieven Huybregts; Patrick Kolsteren; Aroonsri Mongkolchati; Luke C Mullany; Richard Ndyomugyenyi; Jyh Kae Nien; David Osrin; Dominique Roberfroid; Ayesha Sania; Christentze Schmiegelow; Mariangela F Silveira; James Tielsch; Anjana Vaidya; Sithembiso C Velaphi; Cesar G Victora; Deborah Watson-Jones; Robert E Black Journal: Lancet Date: 2013-06-06 Impact factor: 79.321