The implications of diagnosis of small for gestational age fetuses using European and South Asian growth charts: an...

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Neonatology

Background:

• Small for gestational age (SGA) is linked to increased perinatal morbidity and mortality.
• Birth weight and fetal size vary significantly across different populations.
• Accurate antenatal diagnosis of SGA is essential for appropriate management.

Purpose of the Study:

• To evaluate the impact of using Bangladeshi and European antenatal growth charts for SGA diagnosis in Sri Lankan infants.
• To compare perinatal outcomes based on SGA classification using different growth references.
• To determine the clinical significance of SGA diagnosis using population-specific charts.

Main Methods:

• Retrospective review of estimated fetal weight before delivery.
• Classification of infants into three groups based on SGA diagnosis using Bangladeshi and European growth charts.
• Comparison of adverse perinatal outcomes across the identified groups.

Main Results:

• Prevalence of SGA differed significantly: 12.7% (Bangladeshi chart) vs. 51.7% (European chart).
• Infants classified as SGA by the Bangladeshi chart (Group 1) showed significantly higher rates of emergency cesarean section, fetal distress, and intrauterine death.
• No significant outcome differences were observed between infants classified as SGA by European charts only (Group 2) and those not SGA by either chart (Group 3).

Conclusions:

• Only SGA diagnosed using population-based growth charts identifies infants at risk for adverse outcomes.
• The use of non-population-specific growth charts can lead to misdiagnosis of SGA.
• Inappropriate growth chart selection may result in unnecessary medical interventions and management.