International versus national growth charts for identifying small and large-for-gestational age newborns: A population-based study in 15 European countries

The Lancet Regional Health. Europe

Mélanie Durox, MSc¹  Irisa Zile, PhD²  Jelena Isakova³  Katarzyna Szamotulska, PhD⁴  Aline Lecomte, MSc⁵  Tonia Rihs, PhD⁶  Theopisti Kyprianou⁶  Luule Sakkeus, PhD⁷  Béatrice Blondel, PhD⁸  Sylvan Berrut, MSc⁹  Kari Klungsøyr, MD^1,10  Henrique Barros, PhD^1,11  Jennifer Zeitlin, DSc^1,12  Sophie Alexander, PhD^1,13  Miriam Gatt^1,14  Jeannette Klimont, Mag^1,15  Rachael Wood, PhD^1,16  Alice Hocquette, MSc^1,16  Mika Gissler, PhD^1,16 

[1] Corresponding author: Alice Hocquette, INSERM Equipe EPOPé, Maternité Port Royal, 53 avenue de l'Observatoire, 75014 Paris, France.;Department of Population Health, Luxembourg Institute of Health, Luxembourg;Directorate for Health Information and Research, National Obstetric Information Systems (NOIS) Register, Tal-Pietà, Malta;Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway and Department of Global Public Health and Primary Care, University of Bergen, Norway;Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia;Federal Statistical Office FSO, Neuchâtel, Switzerland;Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus;Institute of Hygiene, Health Information Centre, Health Statistics Department, Vilnius, Lithuania;Institute of Mother and Child, Department of Epidemiology and Biostatistics, Warsaw, Poland;Public Health Scotland, Edinburgh and University of Edinburgh, Edinburgh, Scotland;Statistics Austria, Vienna, Austria;THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki and Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden;The Centre for Disease Prevention and Control of Latvia, Riga, Latvia;University of Porto Medical School, Department of Public Health, Forensic Sciences and Medical Education, Porto, Portugal;Université Libre de Bruxelles, School of Public Health, Perinatal Epidemiology and Reproductive health Unit, Brussels, Belgium;Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, F-75004 Paris, France;

关键词: fetal growth;    small for gestational age;    large for gestational age;    fetal growth charts;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: To inform the on-going debate about the use of universal prescriptive versus national intrauterine growth charts, we compared perinatal mortality for small and large-for-gestational-age (SGA/LGA) infants according to international and national charts in Europe. Methods: We classified singleton births from 33 to 42 weeks of gestation in 2010 and 2014 from 15 countries (N = 1,475,457) as SGA (birthweight <10th percentile) and LGA (>90th percentile) using the international Intergrowth-21st newborn standards and national charts based on the customised charts methodology. We computed sex-adjusted odds ratios (aOR) for stillbirth, neonatal and extended perinatal mortality by this classification using multilevel models. Findings: SGA and LGA prevalence using national charts were near 10% in all countries, but varied according to international charts with a north to south gradient (3.0% to 10.1% and 24.9% to 8.0%, respectively). Compared with appropriate for gestational age (AGA) infants by both charts, risk of perinatal mortality was increased for SGA by both charts (aOR[95% confidence interval (CI)]=6.1 [5.6–6.7]) and infants reclassified by international charts from SGA to AGA (2.7 [2.3–3.1]), but decreased for those reclassified from AGA to LGA (0.6 [0.4–0.7]). Results were similar for stillbirth and neonatal death. Interpretation: Using international instead of national charts in Europe could lead to growth restricted infants being reclassified as having normal growth, while infants with low risks of mortality could be reclassified as having excessive growth. Funding: InfAct Joint Action, CHAFEA Grant n°801,553 and EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking ConcePTION grant n°821,520. AH received a PhD grant from EHESP.

【 授权许可】

Unknown