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Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population
Authors:Catharina L D de  Jong Research Fellow  Jason Gardosi Director    Gustaaf A Dekker Senior Lecturer  Gerard J Colenbrander Clinical Physicist    Herman P van  Geijn Professor
Institution:Departments of Obstetrics and Gynaecology, University Hospital, Vrije Universiteit, Amsterdam, The Netherlands;Department of Clinical Physics and Engineering, University Hospital, Vrije Universiteit, Amsterdam, The Netherlands;Perinatal Research and Monitoring Unit, Queen's Medical Centre, Nottingham, UK
Abstract:Objective Physiological as well as pathological variables influence birthweight. The aim of the present study was to examine perinatal outcome in relation to birthweight centiles applying a customised birthweight standard.
Methods Two hundred and seventeen babies from high risk pregnancies were evaluated and classified as small or not small for gestational age according to two standards: 1. conventional Dutch birthweight centiles and 2. customised centiles which adjust individually for physiological variables like maternal booking weight, height and ethnic origin.
Results Customisation of the weight standards resulted in identification of an additional group of infants who were small for gestational age, but not by the Dutch standards. These babies were associated with significantly more adverse perinatal events than those who were not small for gestational age as defined by a customised standard.
Conclusions Adjustment of birthweight centiles for physiological variables significantly improves the identification of infants who have failed to reach the expected birthweight and who are at increased risk for adverse perinatal events.
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