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Pediatrics. 2019 Jul;144(1). pii: e20190076. doi: 10.1542/peds.2019-0076. Epub 2019 Jun 14.

A 2017 US Reference for Singleton Birth Weight Percentiles Using Obstetric Estimates of Gestation.

Author information

1
Harvard Pilgrim Health Care Institute and Division of Chronic Disease Research Across the Lifecourse, Departments of Population Medicine and izzuddin_aris@harvardpilgrim.org.
2
Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
3
Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
4
Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts; and.
5
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
6
Harvard Pilgrim Health Care Institute and Division of Chronic Disease Research Across the Lifecourse, Departments of Population Medicine and.
7
Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, and.
8
Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.

Abstract

OBJECTIVE:

To provide an updated birth weight-for-gestational age (BW-for-GA) reference in the United States by using the most recent, nationally representative birth data with obstetric estimates of gestational age (GA).

METHODS:

We abstracted 3 285 552 singleton births between 22 and 42 weeks' gestation with nonmissing race and/or ethnicity, infant sex, parity, birth weight, and obstetric estimate of GA from the 2017 US natality files. We used 2 techniques (nonlinear, resistant smoothing [4253H] and lambda-mu-sigma) to derive smoothed BW-for-GA curves and compared resulting BW-for-GA cut-points at the third, 10th, 90th, and 97th percentiles with US references from 1999 to 2009.

RESULTS:

The smoothed BW-for-GA curves from both techniques overlapped considerably with each other, with strong agreements seen between the 2 techniques (>99% agreement; κ-statistic >0.9) for BW-for-GA cut-points at the third, 10th, 90th, and 97th percentiles across all GAs. Cut-points from 2017 using the lambda-mu-sigma method captured 9.8% to 10.2% of births <10th and >90th percentiles and 2.6% to 3.3% of births below the third and above the 97th percentile across all GAs. However, cut-points from US references in 1999 and 2009 (when GA was based on last menstrual period) captured a much larger range of proportions of 2017 births at these thresholds, especially among preterm and postterm GA categories.

CONCLUSIONS:

We have provided an updated BW-for-GA reference in the United States using the most recent births with obstetric estimates of GA and information to calculate continuous measures of birth size that are sex or parity specific.

PMID:
31201230
PMCID:
PMC6615520
[Available on 2020-07-01]
DOI:
10.1542/peds.2019-0076

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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