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Am J Perinatol 2005; 22(8): 405-412
DOI: 10.1055/s-2005-872595
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Detecting Small for Gestational Age Infants: The Development of a Population-Based Reference for Washington State

Sherry Lipsky1 , 4 , Thomas R. Easterling2 , Victoria L. Holt1 , Cathy W. Critchlow1 , 3 , 5
  • 1Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
  • 2Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, Washington
  • 3HPV Research Group, University of Washington, Seattle, Washington
  • 4Dr. Lipsky is currently affiliated with the University of Texas School of Public Health at Dallas
  • 5Dr. Critchlow is now affiliated with Amgen, Inc., Thousand Oaks, California
Further Information

Publication History

Publication Date:
17 September 2005 (online)

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ABSTRACT

Small for gestational age (SGA) infants are at increased risk for morbidity and mortality. The objective of this study was to develop a birthweight for gestational age reference that more accurately represents the Washington state population, focusing on SGA. Washington state birth certificate files of singleton births in 1989 to 1998 were used to develop the 3rd, 10th, 50th, and 90th percentiles of birthweight for gestational age for males and females. The Washington state 10th percentile curve most closely approximates a nationally representative reference, whereas an earlier but widely used California-based reference had the lowest centiles across gestational age with few exceptions. Using the Washington reference, 8.4% of Washington births would be classified as SGA (< 10th percentile), compared with 5.5 and 7.4% using the California and national reference, respectively. The new reference may be helpful in assessing local regional data, and other areas with similar demographics, and provide more relevant clinical guidance.

KEYWORDS

Birthweight - gestational age - fetal growth

REFERENCES

  • 1 McIntire D D, Bloom S L, Casey B M, Leveno K J. Birth weight in relation to morbidity and mortality among newborn infants.  N Engl J Med. 1999;  340 1234-1238
    CrossrefPubMedGoogle Scholar
  • 2 Strauss R S. Adult functional outcome of those born small for gestational age: twenty-six-year follow-up of the 1970 British Birth Cohort.  JAMA. 2000;  283 625-632
    CrossrefPubMedGoogle Scholar
  • 3 Brown E. Long-term sequelae of preterm birth. In: Fuchs A, Fuchs F, Stubblefield P Preterm Birth: Causes, Prevention, and Management. New York; McGraw-Hill 1993: 447-492
    Google Scholar
  • 4 Goldenberg R L, Cliver S P. Small for gestational age and intrauterine growth restriction: definitions and standards.  Clin Obstet Gynecol. 1997;  40 704-714
    CrossrefPubMedGoogle Scholar
  • 5 Alexander G R, Kogan M, Martin J, Papiernik E. What are the fetal growth patterns of singletons, twins, and triplets in the United States?.  Clin Obstet Gynecol. 1998;  41 114-125
    PubMedGoogle Scholar
  • 6 Alexander G R, Kogan M D, Himes J H, Mor J M, Goldenberg R. Racial differences in birthweight for gestational age and infant mortality in extremely-low-risk US populations.  Paediatr Perinat Epidemiol. 1999;  13 205-217
    CrossrefPubMedGoogle Scholar
  • 7 Lubchenco L O, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation.  Pediatrics. 1963;  32 793-800
    PubMedGoogle Scholar
  • 8 Williams R L, Creasy R K, Cunningham G C, Hawes W E, Norris F D, Tashiro M. Fetal growth and perinatal viability in California.  Obstet Gynecol. 1982;  59 624-632
    PubMedGoogle Scholar
  • 9 Alexander G R, Kogan M D, Himes J H. 1994-1996 U.S. singleton birth weight percentiles for gestational age by race, Hispanic origin, and gender.  Matern Child Health J. 1999;  3 225-231
    CrossrefPubMedGoogle Scholar
  • 10 Guzman B. The Hispanic population: 2000, Census 2000 Brief. Washington, DC; U.S. Census Bureau May 2001
    Google Scholar
  • 11 McKinnon J. The Black population: 2000, Census 2000 Brief. Washington, DC; U.S. Census Bureau August 2001
    Google Scholar
  • 12 Hobbs F, Stoops N. Demographic trends in the 20th century. Census 2000 Special Reports, Series CENSR-4. Washington, DC; U.S. Census Bureau November 2001
    Google Scholar
  • 13 Fingerhut L A, Kleinman J C. Comparability of reporting between the birth certificate and the 1980 National Natality Survey. Vital Health Stat 2 1985 99: 1-34
    Google Scholar
  • 14 Buescher P A, Taylor K P, Davis M H, Bowling J M. The quality of the new birth certificate data: a validation study in North Carolina.  Am J Public Health. 1993;  83 1163-1165
    CrossrefPubMedGoogle Scholar
  • 15 Piper J M, Mitchel Jr E F, Snowden M, Hall C, Adams M, Taylor P. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.  Am J Epidemiol. 1993;  137 758-768
    PubMedGoogle Scholar
  • 16 Emery III E S, Eaton A, Grether J K, Nelson K B. Assessment of gestational age using birth certificate data compared with medical record data.  Paediatr Perinat Epidemiol. 1997;  11 313-321
    CrossrefPubMedGoogle Scholar
  • 17 Cleveland W. Robust locally weighted regression and smoothing scatterplots.  J Am Stat Assoc. 1979;  74 828-836
    PubMedGoogle Scholar
  • 18 Cleveland W. Visualizing Data. Summit, NJ; Hobart Press 1993
    Google Scholar
  • 19 Ananth C V, Wen S W. Trends in fetal growth among singleton gestations in the United States and Canada, 1985 through 1998.  Semin Perinatol. 2002;  26 260-267
    PubMedGoogle Scholar
  • 20 Cogswell M E, Yip R. The influence of fetal and maternal factors on the distribution of birthweight.  Semin Perinatol. 1995;  19 222-240
    CrossrefPubMedGoogle Scholar
  • 21 Kramer M S. Socioeconomic determinants of intrauterine growth retardation.  Eur J Clin Nutr. 1998;  52(suppl 1) S29-S33
    CrossrefPubMedGoogle Scholar
  • 22 Alexander G R, Kogan M D. Ethnic differences in birth outcomes: the search for answers continues.  Birth. 1998;  25 198-201
    CrossrefPubMedGoogle Scholar
  • 23 Shiono P H, Rauh V A, Park M, Lederman S A, Zuskar D. Ethnic differences in birthweight: the role of lifestyle and other factors.  Am J Public Health. 1997;  87 787-793
    PubMedGoogle Scholar
  • 24 Le L T, Kiely J L, Schoendorf K C. Birthweight outcomes among Asian American and Pacific Islander subgroups in the United States.  Int J Epidemiol. 1996;  25 973-979
    PubMedGoogle Scholar
  • 25 Mongelli M, Gardosi J. Birth weight, prematurity and accuracy of gestational age.  Int J Gynaecol Obstet. 1997;  56 251-256
    CrossrefPubMedGoogle Scholar
  • 26 Mongelli M, Wilcox M, Gardosi J. Estimating the date of confinement: ultrasonographic biometry versus certain menstrual dates.  Am J Obstet Gynecol. 1996;  174 278-281
    CrossrefPubMedGoogle Scholar
  • 27 Todros T, Ronco G, Lombardo D, Gagliardi L. The length of pregnancy: an echographic reappraisal.  J Clin Ultrasound. 1991;  19 11-14
    PubMedGoogle Scholar
  • 28 Waldenstrom U, Axelsson O, Nilsson S. Sonographic dating of pregnancies among women with menstrual irregularities.  Acta Obstet Gynecol Scand. 1991;  70 17-20
    PubMedGoogle Scholar
  • 29 Mustafa G, David R J. Comparative accuracy of clinical estimate versus menstrual gestational age in computerized birth certificates.  Public Health Rep. 2001;  116 15-21
    CrossrefPubMedGoogle Scholar
  • 30 DiPietro J A, Allen M C. Estimation of gestational age: implications for developmental research.  Child Dev. 1991;  62 1184-1199
    PubMedGoogle Scholar
  • 31 Alexander G R, Allen M C. Conceptualization, measurement, and use of gestational age. I: clinical and public health practice.  J Perinatol. 1996;  16 53-59
    PubMedGoogle Scholar

Sherry LipskyPh.D. M.P.H. 

Dallas Regional Campus, University of Texas School of Public Health

5323 Harry Hines Blvd., V8.112, Dallas, TX 75390-9128

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