The Library

Differences between European birthweight standards: impact on classification of ‘small for gestational age’

Tools

Hemming, Karla, Hutton, Jane L., Glinianaia, S. V., Jarvis, S. N. and Platt, M. J.. (2006) Differences between European birthweight standards: impact on classification of ‘small for gestational age’. Developmental Medicine and Child Neurology, Vol.48 (No.11). pp. 906-912. ISSN 0012-1622

Preview

PDF
WRAP_Hutton_Differences_European_birthweight.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (262Kb)

Official URL: http://dx.doi.org/10.1017/S0012162206001988

Abstract

We describe a quantitative and comparative review of a selection of European birthweight standards for gestational age for singletons, to enable appropriate choices to be made for clinical and research use. Differences between median values at term across standards in 10 regions and misclassification of ‘small for gestational age’ (SGA), were studied. Sex and parity differences, exclusion criteria, and methods of construction were considered. There was wide variation between countries in exclusion criteria, methods of calculating standards, and median birthweight at term. The lightest standards (e.g. France's medians are 255g lower than Norway's medians) were associated with fewer exclusion criteria. Up to 20% of the population used in the construction of the Scottish standard would be classified as SGA using the Norwegian standard. Substantial misclassification of SGA is possible. Assumptions about variation used in the construction of some standards were not justified. It is not possible to conclude that there are real differences in birthweight standards between European countries. Country-based standards control for some population features but add misclassification due to the differing ways in which standards are derived. Standards should be chosen to reflect clinical or research need. If standards stratified by sex or parity are not available, adjustments should be made. In multinational studies, comparisons should be made between results using both a common standard and country-based standards.

Item Type:	Journal Article
Subjects:	R Medicine > RJ Pediatrics
Divisions:	Faculty of Science > Statistics
Library of Congress Subject Headings (LCSH):	Birth weight, Low -- Europe, Birth weight, Low -- Standards, Gestational age -- Testing, Medicine -- Statistical methods, Medicine, Comparative -- Europe
Journal or Publication Title:	Developmental Medicine and Child Neurology
Publisher:	Cambridge University Press
ISSN:	0012-1622
Date:	November 2006
Volume:	Vol.48
Number:	No.11
Page Range:	pp. 906-912
Identification Number:	10.1017/S0012162206001988
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	Medical Research Council (Great Britain) (MRC), European Commission (EC)
Grant number:	DGXIIBIOMED2- Contract NBMH4-983701 (EC)
References:	1. Keirse MJNC. (2000) International variations in intrauterine growth. Eur J Obstet Gynecol Reprod Biol 92: 21–28. 2. Jarvis SN, Glinianaia SV, Torrioli MG, Platt MJ, Miceli M, Jouk PS, Johnson A, Hutton J, Hemming K, Hagberg G, et al. (2003) Cerebral palsy and intrauterine growth in single births: a European collaborative study. Lancet 362: 1106–1111. 3. Dahlquist G, Bennich SS, Kallen B. (1996) Intrauterine growth pattern and risk of childhood onset insulin dependent (type I) diabetes: population based case-control study. Br Med J 313: 1174–1177. 4. Wilcox A, Skjaerven R. (1992) Birthweight and perinatal mortality: the effect of gestational age. Am J Publ Health 82: 378–382. 5. Wilcox AJ. (2001) On the importance – and the unimportance – of birthweight. Int J Epidemiol 30: 1233–1241. 6. Forbes JF, Smalls MJ. (1983) A comparative analysis of birthweight for gestational age standards. Br J Obstet Gynaecol 99: 297–303. 7. Graafmans WC, Richardus JH, MacFarlane A, Rebagliato M, Blondel B, Verloove-Vanhorick SP, Mackenbach JP. (2001) Comparability of published perinatal mortality rates in Western Europe: the quantitative impact of differences in gestational age and birthweight criteria. Br J Obstet Gynaecol 109: 1237–1245. 8. Surveillance of Cerebral Palsy in Europe (SCPE) Collaborative Group. (2000) Surveillance of Cerebral Palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol 42: 816–824. 9. Tin W, Wariyar UK, Hey EN. (1997) Selection biases invalidate current low birthweight for gestation standards. Br J Obstet Gynaecol 104: 180–185. 10. Campbell D, Hall M, Lemon J, Carr-Hill R, Pritchard C, Samphier M. (1993) Clinical birthweight standards for a total population in the 1980s. Br J Obstet Gynaecol 100: 436–445. 11. Niklasson A, Ericson A, Fryer JG, Karlberg J, Lawrence C, Karlberg P. (1991) An update on the Swedish reference standards for weight, length and head circumference at birth for given gestational age (1977–1981). Acta Paediatr Scand 80: 756–762. 12. Kallen B. (1995) A birthweight for gestational age standard based on data in the Swedish Medical Birth Registry, 1985–1989. Eur J Epidemiol 11: 601–606. 13. Greisen G, Michaelsen KF. (1989) Perinatal vaekst. Ugeskr Laeger 151: 1813–1815. (In Danish) 14. Mamelle N, Munoz F, Grandjean H. (1996) Fetal growth from the AUDIPOG study. I. Establishment of reference curves. J Gynecol Obstet Biol Reprod (Paris) 25: 61–70. 15. Spano B, Grimaldi MA, Serra GC, Sanna MCA, Sardu MF, Manca MA, Madeddu R, Orzalesi M. (1988) Curve di accrescimento endouterino da 34 a 42 settimane di gravidanza nella provincia di Sassari. Minerva Pediatr 40: 315–319. (In Italian) 16. Skjaerven R, Gjessing HK, Bakketeig LS. (2000) Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand 79: 440–449. 17. Scottish Health Services Common Services Agency. (1990) Scotland: Birthweight, Head Circumference and Length for Gestational Age. Edinburgh: Scottish Health Services Common Services Agency. 18. Yudkin PL, Aboualfa M, Eyre JA, Redman CWG, Wilkinson AR. (1987) New birthweight and head circumference centiles for gestational ages 24 to 42 weeks. Early Hum Dev 15: 45–52. 19. Graafmans WC, Richardus JH, Borsboom GJ, Bakketeig L, Langhoff-Roos J, Bergsjo P, Macfarlaine A, Verloove-Vanhorick SP, Mackenbach JP. (2002) Birthweight and perinatal mortality: comparison of optimal birthweight in seven Western European countries. Epidemiology 5: 569–574.
URI:	http://wrap.warwick.ac.uk/id/eprint/709