Joel G Ray1, Michael Sgro2, Muhammad M Mamdani3, Richard H Glazier4, Alan Bocking5, Robert Hilliard6, Marcelo L Urquia7. 1. Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto ON; Department of Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto ON; Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto ON. 2. Department of Paediatrics, St. Michael's Hospital, University of Toronto, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto O. 3. Department of Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto O; Applied Health Research Centre, St. Michael's Hospital, University of Toronto, Toronto ON. 4. Institute for Clinical Evaluative Sciences, St. Michael's Hospital, Toronto ON; Centre for Research on Inner City Health, St. Michael's Hospital, Toronto ON; Department of Family and Community Medicine, University of Toronto, Toronto ON. 5. Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON; Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON. 6. Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto ON. 7. Centre for Research on Inner City Health, St. Michael's Hospital, Toronto ON.
Abstract
BACKGROUND: Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. METHODS: We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. RESULTS: Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. CONCLUSIONS: Birth weight curves need to be modified for newborns of immigrant mothers originating from non-European/Western nations.
BACKGROUND: Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. METHODS: We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. RESULTS: Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. CONCLUSIONS: Birth weight curves need to be modified for newborns of immigrant mothers originating from non-European/Western nations.
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Authors: Steven Hawken; Malia S Q Murphy; Robin Ducharme; A Brianne Bota; Lindsay A Wilson; Wei Cheng; Ma-Am Joy Tumulak; Maria Melanie Liberty Alcausin; Ma Elouisa Reyes; Wenjuan Qiu; Beth K Potter; Julian Little; Mark Walker; Lin Zhang; Carmencita Padilla; Pranesh Chakraborty; Kumanan Wilson Journal: Gates Open Res Date: 2021-06-21
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