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Customized compared to population-based centiles for detecting term small for gestational age infants in Greece
D Rallis1, P Karagianni1, E Papaharalambous1
1Second Neonatal Intensive Care Unit and Neonatology Department of Aristotle University of Thessaloniki, School of Medicine, Thessaloniki, Greece.
Hippokratia
|July 9, 2021
Summary
Customized centiles more accurately identify small for gestational age (SGA) infants compared to population-based centiles. However, neither method significantly improved prediction of poor perinatal outcomes in this Greek cohort.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Biostatistics
Background:
- Accurate detection of small for gestational age (SGA) infants is crucial for identifying those at risk of morbidity.
- The effectiveness of customized centiles versus population-based centiles in predicting adverse perinatal outcomes remains unclear.
- This study investigates the validity of customized centiles in a Greek cohort for SGA detection and morbidity risk prediction.
Purpose of the Study:
- To evaluate the accuracy of customized centiles in identifying SGA term infants within a Greek population.
- To compare the performance of customized centiles against population-based centiles in predicting perinatal morbidity.
- To assess the clinical utility of adjusted centiles for risk stratification in newborns.
Main Methods:
- Prospective data collection of neonatal and maternal characteristics for singleton, low-risk, term infants over one year.
- Infants classified as SGA based on birth weight below the tenth centile using both population-based and customized centiles (adjusted for maternal/innate factors).
- Comparative analysis using linear regression and receiver operating characteristic (ROC) curves to assess predictive performance.
Main Results:
- Customized centiles identified a higher proportion of SGA infants (12%) compared to population-based centiles (6%).
- Both customized and population-based centiles showed a similar association with perinatal morbidity (OR 1.02).
- No significant difference was observed in predicting perinatal morbidity between customized and population-based centiles (AUC 0.773 vs. 0.737, p=0.272).
Conclusions:
- Customized centiles demonstrate superior accuracy in detecting SGA term infants compared to population-based centiles.
- Despite improved SGA detection, customized centiles did not enhance the prediction of poor perinatal outcomes.
- The findings suggest that while customized centiles improve SGA identification, their role in predicting morbidity requires further investigation.
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