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A New Birthweight Reference by Gestational Age: A Population Study Based on the Generalized Additive Model for
Qiong Wu1, Hui-Yun Zhang2, Li Zhang1
1Department of Pediatrics, Child Health Care Center, The First Affiliated Hospital of Shandong, First Medical University, Jinan, China.
Frontiers in Pediatrics
|April 7, 2022
Summary
A new birthweight reference for Shandong province, China, was created to accurately assess newborns, especially those small for gestational age (SGA). This local standard provides a more precise tool for evaluating infant growth compared to existing international or national curves.
Area of Science:
- Neonatalogy
- Pediatric Growth Standards
- Biostatistics
Background:
- Accurate birthweight references are crucial for assessing newborns, particularly for identifying small for gestational age (SGA) infants.
- Existing regional birthweight standards are lacking for Northern China and specifically for Shandong province.
Purpose of the Study:
- To construct a new, localized birthweight-for-gestational age percentile reference for neonates in Shandong province.
- To compare the newly established reference with existing international (Fenton, INTERGROWTH-21st) and national (Chinese Neonatal Network Standard) curves.
Main Methods:
- Utilized a dataset of 130,911 singleton, live neonates born between 24-42 weeks gestation (2016-2018) in Shandong province.
- Employed the Generalized Additive Model for Location, Scale and Shape (GAMLSS) in R to create the percentile curves.
- Compared the developed curve against Fenton, INTERGROWTH-21st, and Chinese Neonatal Network Standard (2015) curves.
Main Results:
- Established reference values for birthweight by gestational age at the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles.
- Newborns in Shandong generally exhibited higher birthweights compared to Fenton and INTERGROWTH-21st curves across most gestational ages.
- The new reference showed similarities in curve shape to INTERGROWTH-21st and was closer to the Chinese Neonatal Network Standard, with some variations.
Conclusions:
- Significant discrepancies exist among various newborn birthweight assessment criteria.
- Implementing a local birthweight reference, such as the one developed for Shandong province, enhances the accuracy of newborn assessments.
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