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Pediatr Res. 2019 Jun 3. doi: 10.1038/s41390-019-0446-0. [Epub ahead of print]

Comparison of the INTERGROWTH-21st standard and a new reference for head circumference at birth among newborns in Southern China.

Xiao WQ1,2,3, Zhang LF1,2, He JR1,2, Shen SY1, Funk AL4, Lu JH1,2, Wei XL1,2, Yu J2, Yang L2, Li F5, Xia HM1,6, Qiu X7,8,9.

Author information

1
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
2
Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
3
Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
4
Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France.
5
Department of Obstetrics and Gynecology, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
6
Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
7
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China. qxiu0161@163.com.
8
Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China. qxiu0161@163.com.
9
Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China. qxiu0161@163.com.

Abstract

BACKGROUND:

Previous studies proposed that there were racial or ethnic disparities in fetal growth, challenging the use of international standards in specific populations. This study was to evaluate the validity of applying the INTERGROWTH-21st standard to a Chinese population for identifying abnormal head circumference (HC), in comparison with a newly generated local reference.

METHODS:

There were 24,257 singletons delivered by low-risk mothers in four perinatal health-care centers in Southern China. New HC reference was constructed and comparison in distribution of HC categories was performed between the INTERGROWTH-21st standard and new reference after applying these two tools in study population. Logistic regression was used to examine the association between abnormal HC and adverse neonatal outcomes.

RESULTS:

There were 4.40% of the newborns identified with microcephaly (HC > 2 standard deviation below the mean) using the INTERGROWTH-21st standard, comparing to the proportion of 2.83% using new reference. The newborns identified with microcephaly only by the INTERGROWTH-21st standard were not at a higher risk of adverse neonatal outcome, compared with those identified as non-microcephaly by both tools (OR 0.73, 95% CI 0.47-1.13).

CONCLUSION:

The new HC reference may be more appropriate for newborn assessment in Chinese populations than the INTERGROWTH-21st standard.

PMID:
31158843
DOI:
10.1038/s41390-019-0446-0

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