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Italian neonatal birthweight charts derived from INeS not separated by birth order

Elena Spada1, Chiara Peila2, Alessandra Coscia1

  • 1Department of Public Health and Pediatrics, Neonatal Unit, University of Turin, Turin, Italy.

Italian Journal of Pediatrics
|April 28, 2024
PubMed

Insights

New Italian neonatal charts (INeS) not separated by birth order provide reliable birth weight assessment when parity data is missing. These charts aid in identifying small for gestational age (SGA) and large for gestational age (LGA) neonates for better health risk prediction.

Area of Science:

  • Neonatology
  • Pediatric Growth Standards
  • Biostatistics

Background:

  • Accurate assessment of fetal growth is critical for predicting neonatal health risks and guiding early interventions.
  • Small for gestational age (SGA) and large for gestational age (LGA) classifications identify neonates at higher risk for postnatal diseases.
  • Existing Italian neonatal charts (INeS) were previously separated by birth order, accounting for a 3% birth weight difference.

Purpose of the Study:

  • To present new Italian neonatal charts (INeS) for birth weight that are not separated by birth order.
  • To provide a reliable tool for neonatal anthropometric assessment when parity information is unavailable or unreliable.
  • To facilitate comparisons with other international neonatal charts that do not differentiate by birth order.

Main Methods:

  • Utilized a parametric function to trace the non-separated INeS charts for gestational ages from 23 to 42 weeks.
  • Employed the Cole and Green Lambda Mu and Sigma (LMS) model to parametrize the charts.
  • Enabled the computation of standard deviation scores for accurate risk assessment.

Main Results:

  • The centiles of the non-separated INeS charts fall between those of the previously separated first- and later-born charts.
  • Maximum weight differences observed at term were approximately 100g with later-born charts and 70g with first-born charts.
  • The L and S functions exhibited similar shapes for both sexes, with specific peaks indicating growth patterns across gestational ages.

Conclusions:

  • The non-separated Birth Weight INeS charts offer a valuable resource for neonatal health assessment, especially when parity data is absent.
  • The observed differences between separated and non-separated charts were generally small, confirming their reliability.
  • These charts, along with insights from L and S parameters, enhance the standardization and sex/gestational age adjustment of birth weight for defining SGA and LGA neonates, supporting neonatology research and clinical practice.
Abstract

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