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Birth-size reference charts for normal nursery newborns between 35.0 and 41.6 weeks
Fu-Sheng Chou1,2,3,4, Hung-Wen Yeh5,6, Crystal Hsueh7
1Southern California Permanente Medical Group, Pasadena, CA, USA. Fu-Sheng.X.Chou@kp.org.
BMC Pediatrics
|July 10, 2026
Summary
New birth-size charts for newborns improve accuracy in nurseries. Developed using recent data, these charts better identify size percentiles for appropriate infant care.
Area of Science:
- Neonatalogy
- Pediatric Growth Standards
Background:
- Existing birth-size reference charts may inaccurately categorize newborn size, potentially impacting clinical care.
- There is a need for updated reference charts based on current, uncomplicated newborn populations.
Purpose of the Study:
- To develop new, accurate birth-size reference charts (weight, length, head circumference, BMI) for U.S. normal newborn nurseries.
- To compare the performance of new charts against existing references like the Olsen and Fenton charts.
Main Methods:
- Analysis of de-identified data from uncomplicated newborns in U.S. nurseries (2021-2024).
- Exclusion of statistical outliers and recording of gestational age in days.
- Development and validation of birth weight, length, head circumference, and BMI models using a split-sample approach.
Main Results:
- The developed charts demonstrated no overfitting bias.
- New charts more accurately identified the expected 10% of newborns below the 10th percentile and above the 90th percentile.
- Comparison showed improved accuracy over the 2010 Olsen and 2013 Fenton charts.
Conclusions:
- New charts for newborn weight, length, head circumference, and BMI enhance birth-size referencing in normal nurseries.
- These updated charts offer a more precise tool for assessing newborn size and guiding care.
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