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Miranda J, Maestre N, Paternina-Caicedo Á, Parra-Saavedra M, Caradeux J, Sepulveda-Martinez Á, Pelaez-Chomba M, Torres A, Parra-Cordero M, Diaz-Corvillón P, Gallo DM, Santacruz D, Rodriguez N, Sarmiento A, Benavides JA, Girado S, Rojas-Suarez JA, Gratacós E, Figueras F. Performance of the INTERGROWTH-21 st and World Health Organization fetal growth charts for the detection of small-for-gestational age neonates in Latin America. Int J Gynaecol Obstet 2023; 161:1083-1091. [PMID: 36606760 DOI: 10.1002/ijgo.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the performance of INTERGROWTH-21st (IG-21st ) and World Health Organization (WHO) fetal growth charts to identify small-for-gestational-age (SGA) and fetal growth restriction (FGR) neonates, as well as their specific risks for adverse neonatal outcomes. METHODS Multicenter cross-sectional study including 67 968 live births from 10 maternity units across four Latin American countries. According to each standard, neonates were classified as SGA and FGR (birth weight <10th and less than third centiles, respectively). The relative risk (RR) and diagnostic performance for a low APGAR score and low ponderal index were calculated for each standard. RESULTS WHO charts identified more neonates as SGA than IG-21st (13.9% vs 7%, respectively). Neonates classified as having FGR by both standards had the highest RR for a low APGAR (RR, 5.57 [95% confidence interval (CI), 3.99-7.78]), followed by those who were SGA by both curves (RR, 3.27 [95% CI, 2.52-4.24]), while neonates with SGA identified by WHO alone did not have an additional risk (RR, 0.87 [95% CI, 0.55-1.39]). Furthermore, the diagnostic odds ratio for a low APGAR was higher when IG-21st was used. CONCLUSION In a population from Latin America, the WHO charts seem to identify more SGA neonates, but the diagnostic performance of the IG-21st charts for low APGAR score and low ponderal index is better.
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Affiliation(s)
- Jezid Miranda
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia.,Department of Obstetrics and Gynecology, Centro Hospitalario Serena del Mar, Cartagena de Indias, Colombia
| | - Natalia Maestre
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia
| | | | - Miguel Parra-Saavedra
- Centro de Diagnostico y Terapia Fetal del Caribe, Barranquilla, Colombia.,Centro de Investigaciones Clínicas y traslacional, La Misericordia Clínica Internacional y Universidad Simon Bolivar, Barranquilla, Colombia
| | - Javier Caradeux
- Department of Obstetrics and Gynecology, Clínica Santa María, Santiago, Chile
| | - Álvaro Sepulveda-Martinez
- Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico de la Universidad de Chile, Santiago de Chile, Chile.,Fetal Medicine Unit, Department of Obstetrics and Gynecology Clínica Alemana de Santiago, Santiago de Chile, Chile
| | - Melisa Pelaez-Chomba
- Department of Obstetrics and Gynecology, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru
| | - Andrés Torres
- Instituto Mexicano del Seguro Social, Hermosillo, Mexico
| | - Mauro Parra-Cordero
- Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico de la Universidad de Chile, Santiago de Chile, Chile
| | | | - Dahiana M Gallo
- Department of Obstetrics and Gynecology, Universidad del Valle, Cali, Colombia.,Department of Obstetrics and Gynecology, Universidad Libre de Cali, Cali, Colombia
| | - Darío Santacruz
- Department of Obstetrics and Gynecology, Universidad del Valle, Cali, Colombia.,FECOPEN, Federación Colombiana de Asociaciones de Perinatología y Medicina Materno Fetal, Cali, Colombia
| | - Nicolás Rodriguez
- Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Sarmiento
- Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Jesús A Benavides
- Department of Obstetrics and Gynecology, Universidad Tecnológica de Pereira, Clínica San Rafael, Pereira, Colombia
| | - Sergio Girado
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia
| | - José A Rojas-Suarez
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia.,Department of Internal Medicine, University of Cartagena, Cartagena de Indias, Colombia
| | - Eduard Gratacós
- Fetal i+D Fetal Medicine Research, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, (Hospital Clínic - Hospital SJD) Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain
| | - Francesc Figueras
- Fetal i+D Fetal Medicine Research, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, (Hospital Clínic - Hospital SJD) Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain
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