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Customized birthweight standard for a Polish population

Anna Kajdy¹, Oliver Hugh², Jan Modzelewski¹

¹Centre of Postgraduate Medical Education, Department of Reproductive Health, Warsaw, Poland.

Archives of Medical Science : AMS

|December 9, 2024

Insights

Customized birthweight charts in Poland improve detection of fetal growth restriction (FGR) and identify more at-risk newborns compared to the Fenton standard. This personalized approach enhances the identification of adverse outcomes in newborns.

Area of Science:

Obstetrics and Gynecology
Neonatal Health
Biostatistics

Background:

Customized growth charts aid in detecting fetal growth restriction (FGR) and reducing false positives.
Developing population-specific standards is crucial for accurate fetal growth assessment.

Purpose of the Study:

To create a customized birthweight standard for the Polish population.
To compare the effectiveness of a customized standard versus the Fenton standard in identifying at-risk neonates.

Main Methods:

Data from 4,270 pregnancies were analyzed.
Maternal and neonatal variables were collected, including height, weight, ethnicity, gestational age, and complications.
Backward stepwise multiple regression was used to derive coefficients for the customized standard.

Main Results:

The customized standard identified a higher rate of smallness for gestational age (SGA) at 11.9% compared to the Fenton standard at 6.6%.
The customized standard identified significantly more neonates at increased risk for stillbirth, NICU admission, and other complications.
Physiological and pathological factors affecting birthweight, including maternal age and hypertension, were quantified.

Conclusions:

The customized birthweight standard is superior to the Fenton standard for identifying adverse outcomes in SGA neonates within the Polish population.
This customized approach enhances the detection of at-risk pregnancies and improves neonatal care planning.

Read full analysis

Abstract

Introduction:

There is a growing body of evidence supporting the role of customized growth charts in improving detection of fetal growth restriction (FGR) and decreasing false positive diagnoses. The aim of the study is to produce a customised birthweight standard for Poland.

Material And Methods:

Maternal height and weight, ethnicity, gestational age, weight and sex at birth as well as pre-existing and gestational complications were collected. Coefficients were derived using a backwards stepwise multiple regression technique. Smallness for gestational age by the customised standard was compared with the in-use Fenton standard in assessing risk of adverse outcomes using relative risk with 95% confidence intervals.

Results:

Data from 4,270 pregnancies were used as the study cohort. Fenton and customised SGA rates were 6.6% and 11.9%, respectively. The customised standard identified more cases that were at significantly increased risk of stillbirth, admission to neonatal intensive care or other neonatal complications, many of which were missed by the Fenton standard.

Conclusions:

The analysis confirmed the physiological variables that affect birthweight in studies from other countries and was able to quantify additional pathological factors of high maternal age and pregnancy-induced hypertension. Comparison with the Fenton standard showed that adverse outcomes associated with SGA birthweight are better identified by the customised standard in a Polish population.

Keywords:

birthweight customised coefficients gestation related optimal weight neonatal outcome small for gestational age

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