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Randomized Controlled Trial
. 2013 Aug;30(7):565-72.
doi: 10.1055/s-0032-1329188. Epub 2012 Nov 12.

Customized versus population approach for evaluation of fetal overgrowth

Maged M Costantine  1 , Lisa Mele, Mark B Landon, Catherine Y Spong, Susan M Ramin, Brian Casey, Ronald J Wapner, Michael W Varner, Dwight J Rouse, John M Thorp Jr, Anthony Sciscione, Patrick Catalano, Steve N Caritis, Yoram Sorokin, Alan M Peaceman, Jorge E Tolosa, Garland D Anderson; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland
Collaborators, Affiliations
Randomized Controlled Trial

Customized versus population approach for evaluation of fetal overgrowth

Maged M Costantine et al. Am J Perinatol. 2013 Aug.

Abstract

Objective: To compare the ability of customized versus normalized population fetal growth norms in identifying neonates at risk for adverse perinatal outcomes (APOs) associated with fetal overgrowth and gestational diabetes (GDM).

Study design: Secondary analysis of a multicenter treatment trial of mild GDM. The primary outcome was a composite of neonatal outcomes associated with fetal overgrowth and GDM. Birth weight percentiles were calculated using ethnicity- and gender-specific population and customized norms (Gardosi).

Results: Two hundred three (9.8%) and 288 (13.8%) neonates were large for gestational age by population (LGApop) and customized (LGAcust) norms, respectively. Both LGApop and LGAcust were associated with the primary outcome and neonatal hyperinsulinemia, but neither was associated with hypoglycemia or hyperbilirubinemia. The ability of customized and population birth weight percentiles for predicting APOs were poor (area under the receiver operating characteristic curve < 0.6 for six of eight APOs).

Conclusion: Neither customized nor normalized population norms better identify neonates at risk of APOs related to fetal overgrowth and GDM.

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Conflict of interest statement

Disclosure: None of the authors have a conflict of interest

Figures

Figure 1
Figure 1
distribution of neonates classified as large for gestational age (LGA) by the population (LGApop, n=203) and the customized methods (LGAcust, n=288). The diagram also shows the subgroups that are LGA by both methods (n=167) and LGA by population or customized norms only (LGApop-only, n=36 and LGAcust-only, n=121)
See this image and copyright information in PMC

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