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The performance of growth charts in well term newborns in screening for hypoglycemia

Marwa A Khalil1,2, Samantha D'Aversa2, Tara Lozy2,3

  • 1Department of Pediatrics, Division of Neonatology, Hackensack University Medical Center, Hackensack, NJ, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|August 6, 2025
PubMed

Insights

The WHO Growth Chart (WGC) is more sensitive than the Fenton Growth Chart (FGC) for identifying hypoglycemia risk in newborns. Agreement between the charts was poor, highlighting WGC

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Clinical Pediatrics

Background:

  • Hypoglycemia is a common concern in term newborns.
  • Accurate identification of at-risk infants is crucial for timely intervention.
  • Existing growth charts, like the Fenton Growth Chart (FGC) and WHO Growth Chart (WGC), are used to assess infant size and identify potential risks.

Purpose of the Study:

  • To compare the diagnostic performance of the Fenton Growth Chart (FGC) and the WHO Growth Chart (WGC) in identifying term infants at risk for hypoglycemia.
  • To evaluate the agreement between FGC and WGC in classifying infants based on size for hypoglycemia screening.

Main Methods:

  • A retrospective study design was employed.
  • Infants were screened for hypoglycemia based on Small for Gestational Age (SGA) or Large for Gestational Age (LGA) status determined by either FGC or WGC.
  • Data from 970 infants were analyzed to compare the sensitivity and specificity of the two growth charts.

Main Results:

  • There was a low agreement (47.7%) between the FGC and WGC.
  • Out of 970 infants, 29.2% developed hypoglycemia.
  • The WGC demonstrated higher sensitivity in detecting all categories of hypoglycemia (e.g., 81.3% vs. 72.4% for general hypoglycemia) compared to the FGC, while the FGC showed higher specificity.

Conclusions:

  • The WGC is more sensitive than the FGC for detecting hypoglycemia in term infants.
  • Poor agreement exists between the FGC and WGC for identifying hypoglycemia risk.
  • The WGC is a potentially superior tool for screening term infants for hypoglycemia due to its higher sensitivity.
Abstract

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