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Customized birthweight centiles predict SGA pregnancies with perinatal morbidity
Lesley M E McCowan1, Jane E Harding, Alistair W Stewart
1Department of Obstetrics and Gynaecology, National Women's Hospital, University of Auckland, New Zealand.
Summary
Customized birthweight centiles better identify babies at risk of perinatal morbidity and mortality compared to population centiles. This approach detects more at-risk infants, improving perinatal care outcomes.
Area of Science:
- Perinatal Medicine
- Neonatology
- Obstetrics
Background:
- Accurate identification of small for gestational age (SGA) infants is crucial for managing perinatal risks.
- Population-based centiles may misclassify infants, potentially missing those at higher risk.
- Customized centiles, accounting for maternal and fetal factors, may offer improved accuracy.
Purpose of the Study:
- To compare the proportion of babies reclassified using customized versus population centiles.
- To assess the relative risks of perinatal morbidity in infants classified as SGA by both methods.
Main Methods:
- A cohort study involving SGA pregnancies (n=374) and a general obstetric population (n=12,879).
- Comparison of pregnancy outcomes based on classification using population and customized birthweight centiles.
- Analysis of perinatal death and newborn morbidity, including abnormal umbilical Doppler studies.
Main Results:
- Customized centiles identified a higher proportion of infants at risk compared to population centiles.
- Infants classified as 'SGA both' or 'customized SGA only' showed increased perinatal death and newborn morbidity.
- No perinatal deaths were observed in the 'population SGA only' group, with low morbidity.
Conclusions:
- Customized birthweight centiles are effective in identifying small infants at risk of adverse perinatal outcomes.
- Utilizing customized centiles is likely to detect more infants at risk of perinatal morbidity and mortality than population centiles.