[Under diagnosis of fetal growth restriction by the new growth curves of the Chilean Ministry of Health].
BACKGROUND
Fetal growth restriction (FGR) is associated with increased risk of perinatal morbidity or death. Nationwide implementation of new fetal growth charts, requires a lower fetal weight for the diagnosis of FGR, compared to previous ones. This may lead to an under diagnosis of FGR in a large proportion of neonates.


OBJECTIVE
To compare the morbidity, mortality and anthropometry of neonates with FGR, diagnosed by MINSAL and Juez curves, with normal weight newborns in the same period (2000-2004).


METHODS
Revision of medical records of all births occurring in a maternity hospital between 2000 and 2004. The number of neonatal deaths, and the presence of hyperbilirubinemia, polyglobulia, hypoglycemia and hypothermia, were compared among children classified to be below percentile 10 of fetal growth according to both growth charts.


RESULTS
FGR was diagnosed in 4,4% (502/11.289) and 9% (1.029/11.289) of newborns by MINSAL and Juez curves respectively. Compared to normal weight controls, the 527 newborns without FGR according to MINSAL curves, but below percentile 10 of Juez curves, had an odds ratio (OR) for polyglobulina of 8.14 (95% confidence intervals (CI): 1.01-65.34), an OR for neonatal hypoglycemia of 5.10 (95% CI: 1.11-23.39) and an OR for a ponderal index below 10th percentile of 10.98 (95% CI: 6.84-17.64).


CONCLUSIONS
Newborns without a diagnosis of FGR by MINSAL curves but below 10th percentile by Juez curves, have neonatal outcomes suggesting a true FGR. Juez curves should be maintained as a standard for the evaluation of fetal growth in our population.
Carvajal
Jorge A
JA
Departamento de Obstetricia y Ginecología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile. jcarva@med.puc.cl
Vera
Claudio
C
Vargas
Paula
P
Jordán
Felipe
F
Patillo
Alejandro
A
Oyarzún
Enrique
E
D001724:Birth Weight / Q000502:physiology; D016022:Case-Control Studies; D002677:Chile / Q000453:epidemiology; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology; D007003:Hypoglycemia / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology; D007231:Infant, Newborn; D016017:Odds Ratio; D054238:Perinatal Mortality; D012015:Reference Standards