Parity-Adjusted Term Neonatal Growth Chart Modifies Neonatal Morbidity and Mortality Risk Stratification

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Updated: Sep 20, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

86.4K

Roie Kofman1, Rivka Farkash2, Misgav Rottenstreich2

  • 1Department of Internal Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, Jerusalem 91120, Israel.

Journal of Clinical Medicine
|June 10, 2022
PubMed

Insights

Using parity-customized charts for birth weight identification significantly improves the detection of small for gestational age (SGA) neonates at higher risk for adverse outcomes. This approach enhances neonatal risk assessment for better clinical management.

Area of Science:

  • Neonatology
  • Perinatal Epidemiology
  • Obstetrics

Background:

  • Accurate identification of neonates who are small for gestational age (SGA) or large for gestational age (LGA) is crucial for predicting adverse outcomes.
  • Standard population-based birth weight charts may not adequately account for individual maternal factors like parity, potentially leading to misclassification of neonatal size.

Purpose of the Study:

  • To compare the effectiveness of parity-customized birth weight charts versus standard population-based charts in identifying neonatal risk.
  • To assess the impact of these different charting methods on the identification of SGA and LGA infants and their associated morbidities.

Main Methods:

  • An observational, retrospective cohort study analyzed 132,815 singleton, term neonates using electronic birth records (2006-2017).
  • Neonates were classified as SGA, LGA, or appropriate for gestational age (AGA) using both population-based (POP) and parity-customized (CUST) models.
  • Specific focus was on neonates identified differently by each model (SGA/LGA CUST/POP ONLY).

Main Results:

  • The customized model identified 53% more SGA neonates (SGA-CUST ONLY), who exhibited significantly higher rates of morbidity and mortality (OR = 1.33).
  • Neonates identified as LGA by the customized model but AGA by the population model (LGA-CUST ONLY) showed increased morbidity risk (OR = 1.36).
  • Neonatal mortality was exclusively observed in the SGA and AGA groups.

Conclusions:

  • Parity-customized birth weight charts are a simple yet effective tool for improving the identification of neonatal risk for morbidity and mortality.
  • This method offers a better platform for risk stratification in term neonates compared to standard population-based charts.

Keywords:
birth weight chartslarge for gestational ageneonatal outcomessmall for gestational age

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