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. 2023 Jun 14:11:1173685.
doi: 10.3389/fped.2023.1173685. eCollection 2023.

Regional references vs. international standards for assessing weight and length by gestational age in Lithuanian neonates

Ruta Morkuniene  1 , Tim J Cole  2 , Egle Marija Jakimaviciene  1 , Agne Bankauskiene  3 , Jelena Isakova  4 , Nijole Drazdiene  5 , Vytautas Basys  6 , Janina Tutkuviene  1
Affiliations

Regional references vs. international standards for assessing weight and length by gestational age in Lithuanian neonates

Ruta Morkuniene et al. Front Pediatr. .

Abstract

Introduction: There is no global consensus as to which standards are the most appropriate for the assessment of birth weight and length. The study aimed to compare the applicability of regional and global standards to the Lithuanian newborn population by sex and gestational age, based on the prevalence of small or large for gestational age (SGA/LGA).

Materials and methods: Analysis was performed on neonatal length and weight data obtained from the Lithuanian Medical Birth Register from 1995 to 2015 (618,235 newborns of 24-42 gestational weeks). Their distributions by gestation and sex were estimated using generalized additive models for location, scale, and shape (GAMLSS), and the results were compared with the INTERGROWTH-21st (IG-21) standard to evaluate the prevalence of SGA/LGA (10th/90th centile) at different gestational ages.

Results: The difference in median length at term between the local reference and IG-21 was 3 cm-4 cm, while median weight at term differed by 200 g. The Lithuanian median weight at term was higher than in IG-21 by a full centile channel width, while the median length at term was higher by two channel widths. Based on the regional reference, the prevalence rates of SGA/LGA were 9.7%/10.1% for boys and 10.1%/9.9% for girls, close to the nominal 10%. Conversely, based on IG-21, the prevalence of SGA in boys/girls was less than half (4.1%/4.4%), while the prevalence of LGA was double (20.7%/19.1%).

Discussion: Regional population-based neonatal references represent Lithuanian neonatal weight and length much more accurately than the global standard IG-21 which provides the prevalence rates for SGA/LGA that differ from the true values by a factor of two.

Keywords: LGA (large for gestational age); SGA (small for gestational age); birth; global; growth charts; newborns; preterm (birth); regional.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the sampling procedure and exclusion criteria in this study. BW, birth weight; BL, birth length; n, number; SD, standard deviation.
Figure 2
Figure 2
The 3rd, 10th, 25th, 50th, 75th, 90th and 97th smoothed centile curves for birth weight (g) in Lithuanian boys and the 3rd, 10th, 50th, 90th and 97th centiles for INTERGROWTH-21st.
Figure 3
Figure 3
The 3rd, 10th, 25th, 50th, 75th, 90th and 97th smoothed centile curves for birth weight (g) in Lithuanian girls and the 3rd, 10th, 50th, 90th and 97th centiles for INTERGROWTH-21st.
Figure 4
Figure 4
The 3rd, 10th, 25th, 50th, 75th, 90th and 97th smoothed centile curves for birth length (cm) in Lithuanian boys and the 3rd, 10th, 50th, 90th and 97th centiles for INTERGROWTH-21st.
Figure 5
Figure 5
The 3rd, 10th, 25th, 50th, 75th, 90th and 97th smoothed centile curves for birth length (cm) in Lithuanian girls and the 3rd, 10th, 50th, 90th and 97th centiles for INTERGROWTH-21st.
See this image and copyright information in PMC

References

    1. Rugolo LS. Growth and developmental outcomes of the extremely preterm infant. J Pediatr (Rio J). (2005) 81:S101–10. 10.2223/1309 - DOI - PubMed
    1. Chiavaroli V, Marcovecchio ML, de Giorgis T, Diesse L, Chiarelli F, Mohn A. Progression of cardio-metabolic risk factors in subjects born small and large for gestational age. PLoS One. (2014) 9(8):e104278. 10.1371/journal.pone.0104278 - DOI - PMC - PubMed
    1. WHO Expert Committee on Physical Status: the Use and Interpretation of Anthropometry (1993: Geneva S, Organization WH). Physical status: the use of and interpretation of anthropometry, report of a WHO expert committee. World Health Organization. (1995). Available at: https://apps.who.int/iris/handle/10665/37003 (Cited February 1, 2023). - PubMed
    1. Smith GCS, Lees CC. Disorders of fetal growth and assessment of fetal well-being. In: Edmonds DK, editor. Dewhurst’s textbook of obstetrics & gynaecology. London, UK: John Wiley & Sons, Ltd; (2012). p. 200–7. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119979449.ch18 (Cited February 1, 2023). - DOI
    1. Casey PH. Growth of low birth weight preterm children. Semin Perinatol. (2008) 32(1):20–7. 10.1053/j.semperi.2007.12.004 - DOI - PubMed

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