Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort

Maged M. Costantine; Yinglei Lai; Steven L. Bloom; Catherine Y. Spong; Michael W. Varner; Dwight J. Rouse; Susan M. Ramin; Steve N. Caritis; Alan M. Peaceman; Yoram Sorokin; Anthony Sciscione; Brian M. Mercer; John M. Thorp; Fergal D. Malone; Margaret Harper; Jay D. Iams

doi:10.1055/s-0032-1324708

Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort

Maged M. Costantine, Yinglei Lai, Steven L. Bloom, Catherine Y. Spong, Michael W. Varner, Dwight J. Rouse, Susan M. Ramin, Steve N. Caritis, Alan M. Peaceman, Yoram Sorokin, Anthony Sciscione, Brian M. Mercer, John M. Thorp, Fergal D. Malone, Margaret Harper, Jay D. Iams

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Objective To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA). Study Design Secondary analysis of an intrapartum fetal pulse oximetry trial in nulliparous women at term. Birth weight percentiles were calculated using ethnicity- and gender-specific population norms and customized norms (Gardosi). Results Of the studied neonates, 508 (9.9%) and 584 (11.3%) were SGA by population (SGApop) and customized (SGAcust) norms, respectively. SGApop infants were significantly associated with a composite adverse neonatal outcome, neonatal intensive care admission, low fetal oxygen saturation, and reduced risk of cesarean delivery; both SGApop and SGAcust infants were associated with a 5-minute Apgar score < 4. The ability of customized and population birth weight percentiles in predicting APO was poor (12 of 14 APOs had area under the curve of <0.6). Conclusion In this intrapartum cohort, neither customized nor normalized population norms adequately identified neonates at risk of APO related to SGA.

Original language	English (US)
Pages (from-to)	335-341
Number of pages	7
Journal	American Journal of Perinatology
Volume	30
Issue number	4
DOIs	https://doi.org/10.1055/s-0032-1324708
State	Published - 2013

Keywords

adverse outcomes
customized norm
fetal growth
small for gestational age

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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10.1055/s-0032-1324708

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Costantine, M. M., Lai, Y., Bloom, S. L., Spong, C. Y., Varner, M. W., Rouse, D. J., Ramin, S. M., Caritis, S. N., Peaceman, A. M., Sorokin, Y., Sciscione, A., Mercer, B. M., Thorp, J. M., Malone, F. D., Harper, M., & Iams, J. D. (2013). Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort. American Journal of Perinatology, 30(4), 335-341. https://doi.org/10.1055/s-0032-1324708

Costantine, MM, Lai, Y, Bloom, SL , Spong, CY, Varner, MW, Rouse, DJ, Ramin, SM, Caritis, SN, Peaceman, AM, Sorokin, Y, Sciscione, A, Mercer, BM, Thorp, JM, Malone, FD, Harper, M & Iams, JD 2013, 'Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort', American Journal of Perinatology, vol. 30, no. 4, pp. 335-341. https://doi.org/10.1055/s-0032-1324708

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abstract = "Objective To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA). Study Design Secondary analysis of an intrapartum fetal pulse oximetry trial in nulliparous women at term. Birth weight percentiles were calculated using ethnicity- and gender-specific population norms and customized norms (Gardosi). Results Of the studied neonates, 508 (9.9%) and 584 (11.3%) were SGA by population (SGApop) and customized (SGAcust) norms, respectively. SGApop infants were significantly associated with a composite adverse neonatal outcome, neonatal intensive care admission, low fetal oxygen saturation, and reduced risk of cesarean delivery; both SGApop and SGAcust infants were associated with a 5-minute Apgar score < 4. The ability of customized and population birth weight percentiles in predicting APO was poor (12 of 14 APOs had area under the curve of <0.6). Conclusion In this intrapartum cohort, neither customized nor normalized population norms adequately identified neonates at risk of APO related to SGA.",

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author = "Costantine, {Maged M.} and Yinglei Lai and Bloom, {Steven L.} and Spong, {Catherine Y.} and Varner, {Michael W.} and Rouse, {Dwight J.} and Ramin, {Susan M.} and Caritis, {Steve N.} and Peaceman, {Alan M.} and Yoram Sorokin and Anthony Sciscione and Mercer, {Brian M.} and Thorp, {John M.} and Malone, {Fergal D.} and Margaret Harper and Iams, {Jay D.}",

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doi = "10.1055/s-0032-1324708",

language = "English (US)",

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AU - Lai, Yinglei

AU - Bloom, Steven L.

AU - Spong, Catherine Y.

AU - Varner, Michael W.

AU - Rouse, Dwight J.

AU - Ramin, Susan M.

AU - Caritis, Steve N.

AU - Peaceman, Alan M.

AU - Sorokin, Yoram

AU - Sciscione, Anthony

AU - Mercer, Brian M.

AU - Thorp, John M.

AU - Malone, Fergal D.

AU - Harper, Margaret

AU - Iams, Jay D.

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N2 - Objective To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA). Study Design Secondary analysis of an intrapartum fetal pulse oximetry trial in nulliparous women at term. Birth weight percentiles were calculated using ethnicity- and gender-specific population norms and customized norms (Gardosi). Results Of the studied neonates, 508 (9.9%) and 584 (11.3%) were SGA by population (SGApop) and customized (SGAcust) norms, respectively. SGApop infants were significantly associated with a composite adverse neonatal outcome, neonatal intensive care admission, low fetal oxygen saturation, and reduced risk of cesarean delivery; both SGApop and SGAcust infants were associated with a 5-minute Apgar score < 4. The ability of customized and population birth weight percentiles in predicting APO was poor (12 of 14 APOs had area under the curve of <0.6). Conclusion In this intrapartum cohort, neither customized nor normalized population norms adequately identified neonates at risk of APO related to SGA.

AB - Objective To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA). Study Design Secondary analysis of an intrapartum fetal pulse oximetry trial in nulliparous women at term. Birth weight percentiles were calculated using ethnicity- and gender-specific population norms and customized norms (Gardosi). Results Of the studied neonates, 508 (9.9%) and 584 (11.3%) were SGA by population (SGApop) and customized (SGAcust) norms, respectively. SGApop infants were significantly associated with a composite adverse neonatal outcome, neonatal intensive care admission, low fetal oxygen saturation, and reduced risk of cesarean delivery; both SGApop and SGAcust infants were associated with a 5-minute Apgar score < 4. The ability of customized and population birth weight percentiles in predicting APO was poor (12 of 14 APOs had area under the curve of <0.6). Conclusion In this intrapartum cohort, neither customized nor normalized population norms adequately identified neonates at risk of APO related to SGA.

KW - adverse outcomes

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Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort

Abstract

Keywords

ASJC Scopus subject areas

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