Standards for the Measurement of Birth Weight, Length and Head Circumference at Term in Neonates of European, Chinese and South Asian Ancestry

Overview

Journal Open Med

Date 2010 Jan 27

PMID 20101298

Citations 28

Authors

Patricia A Janssen

Paul Thiessen

Michael C Klein

Michael F Whitfield

Ying C MacNab

Sue C Cullis-Kuhl

Affiliations

Soon will be listed here.

Abstract

Background: Fetal growth restriction is associated with metabolic derangements in the newborn, impaired functioning in childhood and chronic diseases in adulthood. Differences between ethnic groups with respect to fetal growth may result in the misclassification of constitutionally small or large babies as having abnormal growth for their gestational age. We have developed intrauterine growth charts based on precise measurements of newborns whose parents were both of European, Chinese or South Asian ethnicity.

Methods: Weight, length and head circumference were measured in 2695 infants born to healthy non-smoking mothers in British Columbia at 37-41 completed weeks of gestation. Gestational age was confirmed by ultrasound before 20 weeks of gestation. Weight was measured by digital scale, length by stadiometer and head circumference by firm plastic tape measures. Means and 95% confidence intervals were compared among newborns grouped by ethnicity and sex. Smoothed graphs were constructed for visual interpretation.

Results: At 40 weeks, infants of European descent ("European" infants) weighed 225.5 g more on average than infants of Chinese descent ("Chinese" infants) (p < 0.001) and 254.6 g more than infants of South Asian descent ("South Asian" infants) (p < 0.001). The mean difference in birth weight between Chinese and South Asian infants (19.1 g) was not statistically significant. The mean length of European infants at 40 weeks of gestation was 0.89 cm greater than that of Chinese infants (p < 0.001). Differences in mean length between European and South Asian babies or between Chinese and South Asian babies was not statistically significant. The mean head circumferance of European babies was 0.50 cm larger than that of Chinese babies at 40 weeks (p < 0.001) but did not differ significantly from that of South Asian babies. South Asian and Chinese babies had similar mean head circumferences at 40 weeks. When differences in mean birth weight, length and head circumference were examined within boys and girls, the observed differences according to ethnicity remained statistically significant.

Conclusion: Important differences in weight, length and head circumferences are reported among babies according to ethnicity. The use of sex- and ethnicity-specific growth charts may prevent the misclassification of newborns as small or large for gestational age.

Citing Articles

Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study.

Chan D, Zheng R, Beh E, Heng T, Chandran S, Yap F BMJ Paediatr Open. 2024; 8(1).

PMID: 39489526 PMC: 11535710. DOI: 10.1136/bmjpo-2024-002864.

The role of a digital twin in supporting criminal investigations - a case report about a possible abuse.

Becker S, Fritzsch T, Labudde D Forensic Sci Med Pathol. 2024; .

PMID: 39023691 DOI: 10.1007/s12024-024-00857-w.

Perinatal and neonatal risk factors for retinopathy of prematurity in very low birthweight, very preterm twins: a population-based study.

Shemesh R, Strauss T, Zaslavsky-Paltiel I, Lerner-Geva L, Reichman B, Wygnanski-Jaffe T Eye (Lond). 2023; 38(5):902-909.

PMID: 37925560 PMC: 10965998. DOI: 10.1038/s41433-023-02801-8.

Congenital Microcephaly: A Debate on Diagnostic Challenges and Etiological Paradigm of the Shift from Isolated/Non-Syndromic to Syndromic Microcephaly.

Asif M, Abdullah U, Nurnberg P, Tinschert S, Hussain M Cells. 2023; 12(4).

PMID: 36831309 PMC: 9954724. DOI: 10.3390/cells12040642.

Maternal mental health and social support from online communities during pregnancy.

Jiang L, Zhu Z Health Soc Care Community. 2022; 30(6):e6332-e6344.

PMID: 36256486 PMC: 10092248. DOI: 10.1111/hsc.14075.

References

Conley D, Bennett N . Race and the inheritance of low birth weight. Soc Biol. 2001; 47(1-2):77-93. DOI: 10.1080/19485565.2000.9989011. View

Gardosi J . Customized fetal growth standards: rationale and clinical application. Semin Perinatol. 2004; 28(1):33-40. DOI: 10.1053/j.semperi.2003.12.002. View

Kramer M, Platt R, Yang H, McNamara H, Usher R . Are all growth-restricted newborns created equal(ly)?. Pediatrics. 1999; 103(3):599-602. DOI: 10.1542/peds.103.3.599. View

Brodsky D, Christou H . Current concepts in intrauterine growth restriction. J Intensive Care Med. 2004; 19(6):307-19. DOI: 10.1177/0885066604269663. View

Maldonado G, Greenland S . Simulation study of confounder-selection strategies. Am J Epidemiol. 1993; 138(11):923-36. DOI: 10.1093/oxfordjournals.aje.a116813. View

Emanuel I, Kimpo C, Moceri V . The association of maternal growth and socio-economic measures with infant birthweight in four ethnic groups. Int J Epidemiol. 2004; 33(6):1236-42. DOI: 10.1093/ije/dyh269. View

Usher R, McLean F . Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr. 1969; 74(6):901-10. DOI: 10.1016/s0022-3476(69)80224-6. View

Vangen S, Stoltenberg C, Skjaerven R, Magnus P, Harris J, Stray-Pedersen B . The heavier the better? Birthweight and perinatal mortality in different ethnic groups. Int J Epidemiol. 2002; 31(3):654-60. DOI: 10.1093/ije/31.3.654. View

Lin C, EMANUEL I . A comparison of American and Chinese intrauterine growth standards. Are American babies really smaller?. Am J Epidemiol. 1972; 95(5):418-30. DOI: 10.1093/oxfordjournals.aje.a121409. View

10.

Wang X, Guyer B, Paige D . Differences in gestational age-specific birthweight among Chinese, Japanese and white Americans. Int J Epidemiol. 1994; 23(1):119-28. DOI: 10.1093/ije/23.1.119. View

11.

Cheng M, Chew P, Ratnam S . Birth weight distribution of Singapore Chinese, Malay and Indian infants from 34 weeks to 42 weeks gestation. J Obstet Gynaecol Br Commonw. 1972; 79(2):149-53. DOI: 10.1111/j.1471-0528.1972.tb15770.x. View

12.

Veening M, van Weissenbruch M, Delemarre-van de Waal H . Glucose tolerance, insulin sensitivity, and insulin secretion in children born small for gestational age. J Clin Endocrinol Metab. 2002; 87(10):4657-61. DOI: 10.1210/jc.2001-011940. View

13.

Wilcox M, Gardosi J, Mongelli M, Ray C, Johnson I . Birth weight from pregnancies dated by ultrasonography in a multicultural British population. BMJ. 1993; 307(6904):588-91. PMC: 1678907. DOI: 10.1136/bmj.307.6904.588. View

14.

Synnes A, Ling E, Whitfield M, MacKinnon M, Lopes L, Wong G . Perinatal outcomes of a large cohort of extremely low gestational age infants (twenty-three to twenty-eight completed weeks of gestation). J Pediatr. 1994; 125(6 Pt 1):952-60. DOI: 10.1016/s0022-3476(05)82015-3. View

15.

Stein Z, Susser M . Intrauterine growth retardation: epidemiological issues and public health significance. Semin Perinatol. 1984; 8(1):5-14. View

16.

Low J, Burke S, Peters R, Pater E, Killen H, Derrick E . Association of intrauterine fetal growth retardation and learning deficits at age 9 to 11 years. Am J Obstet Gynecol. 1992; 167(6):1499-505. DOI: 10.1016/0002-9378(92)91727-r. View

17.

Yip R, Li Z, Chong W . Race and birth weight: the Chinese example. Pediatrics. 1991; 87(5):688-93. View

18.

Joseph K, Kramer M, Allen A, Cyr M, Fair M, Ohlsson A . Gestational age- and birthweight-specific declines in infant mortality in Canada, 1985-94. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Paediatr Perinat Epidemiol. 2000; 14(4):332-9. DOI: 10.1046/j.1365-3016.2000.00298.x. View

19.

Blidner I, McClemont S, Anderson G, Sinclair J . Size-at-birth standards for an urban Canadian population. Can Med Assoc J. 1984; 130(2):133-40. PMC: 1875889. View

20.

Kramer M, Platt R, Wen S, Joseph K, Allen A, Abrahamowicz M . A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics. 2001; 108(2):E35. DOI: 10.1542/peds.108.2.e35. View