Irene M Beune1, Frank H Bloomfield2, Wessel Ganzevoort3, Nicholas D Embleton4, Paul J Rozance5, Aleid G van Wassenaer-Leemhuis6, Klaske Wynia7, Sanne J Gordijn8. 1. Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: Irenebeune@hotmail.com. 2. Liggins Institute, University of Auckland, Auckland, New Zealand. 3. Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 4. Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. 5. Perinatal Research Center, Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO. 6. Department of Pediatrics, Academic Medical Center, Amsterdam, The Netherlands. 7. Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 8. Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
OBJECTIVE: To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. STUDY DESIGN: An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. RESULTS: In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight <10th percentile; head circumference <10th percentile; length <10th percentile; prenatal diagnosis of fetal growth restriction; and maternal pregnancy information. CONCLUSIONS: Consensus was reached on a definition for growth restriction in the newborn. This definition recognizes that infants with birth weights <10th percentile may not be growth restricted and that infants with birth weights >10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction.
OBJECTIVE: To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. STUDY DESIGN: An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. RESULTS: In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight <10th percentile; head circumference <10th percentile; length <10th percentile; prenatal diagnosis of fetal growth restriction; and maternal pregnancy information. CONCLUSIONS: Consensus was reached on a definition for growth restriction in the newborn. This definition recognizes that infants with birth weights <10th percentile may not be growth restricted and that infants with birth weights >10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction.
Authors: Ali Ghanchi; Neil Derridj; Damien Bonnet; Nathalie Bertille; Laurent J Salomon; Babak Khoshnood Journal: Int J Environ Res Public Health Date: 2020-04-28 Impact factor: 3.390
Authors: Johannes K Steinweg; Grace Tin Yan Hui; Maximilian Pietsch; Alison Ho; Milou Pm van Poppel; David Lloyd; Kathleen Colford; John M Simpson; Reza Razavi; Kuberan Pushparajah; Mary Rutherford; Jana Hutter Journal: Placenta Date: 2021-03-09 Impact factor: 3.481