Document Detail

A comparison of customized and population-based birth-weight standards: the influence of gestational age.
MedLine Citation:
PMID:  19581044     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We examined how customized birth-weight standards compare to population birth-weight references at term (> or =37 weeks), nearly term (34-36 weeks), moderately preterm (32-33 weeks) and for the very preterm births (28-31 weeks), with respect to perinatal mortality.
STUDY DESIGN: Data from the national Swedish Medical Births Register for the years 1992-2001, consisting of a total of 783,303 singletons born at or after 28 completed gestational weeks. Infants were classified as small for gestational age (SGA, <10th centile) according to a conventional population based birth-weight reference and a customized standard. Risk ratios (RR) for still birth and neonatal death were compared between standards by prematurity of the birth. Diagnostic performance measures of specificity, sensitivity and positive and negative predictive values were also evaluated.
RESULTS: More than half, 59% (209), of the 355 infants still-born between 28 and 31 weeks gestation were classified as SGA by the customized standard, but only 23% (80), were so classified as SGA by the population reference. However, only 14% (95%CI 13-16) of the 1461 very preterm infants classified as SGA by the customized standard were still-born, compared to 23% (95%CI 19-28) of the 348 infants classified as SGA by the population reference. Therefore, the relative risk of still birth for those classified as SGA by the customized standard is lower, 2.02 (95%CI: 1.65, 2.46), than for the population reference 2.64 (95%CI: 2.11, 3.30). Similar results were observed for the risk of neonatal death. For term weeks, customized standards showed stronger relationships than population references (RR: 4.30 (95%CI 3.82, 4.84) vs. 4.00 (95%CI 3.55, 4.51) for still births).
CONCLUSIONS: Customized standards categorize a higher absolute number of preterm infants who are still-born as SGA. However, infants classified as SGA by population references are at higher risk of perinatal mortality than infants classified as SGA by customized standards.
Karla Hemming; Jane L Hutton; Sandra Bonellie
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-05
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  146     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-10-20     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  41-5     Citation Subset:  IM    
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MeSH Terms
Birth Weight*
Gestational Age*
Infant, Newborn*
Infant, Premature / physiology*
Infant, Small for Gestational Age / physiology
Perinatal Mortality
Population Surveillance
Reference Standards
Reference Values
Grant Support
G0400642//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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