title: Population standards of birth weight underestimate fetal growth abnormalities in diabetic pregnancies.
abstract: The objective of this study was to compare the frequency of abnormal fetal growth in women with diabetes mellitus (DM) using population-based birth weight (pop BW) percentiles compared with customized birth weight (cust BW) percentiles, which include adjustments for maternal race, parity, height, weight, and fetal sex. The study design comprised a retrospective cohort of singleton DM pregnancies delivered over a 1-year period (June 2007 to May 2008) from a single tertiary care university-based medical center. Inclusion criteria were gestational age >20 weeks at delivery, live birth, and absence of major chromosomal/structural abnormalities. Small for gestational age (SGA), <10th percentile, and large for gestational age (LGA), >90th percentile pregnancies were categorized based on pop BW or cust BW standards. There were significant differences in the rates of SGA (p < 0.004) and LGA (p < 0.001) between cust BW and pop BW methods. When comparing the two methods, pop BW did not identify 13/16 (81%) of SGA and 23/39 (59%) of LGA babies defined by cust BW methods. The use of cust BW calculation in a diabetic population identified a greater percentage of neonates with pathologic fetal growth compared with pop BW standards, suggesting that the population standard may underdiagnose abnormal fetal growth in diabetic pregnancies.
authors: Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, 77030, USA. benjamin.a.kase@uth.tmc.edu
authors: Benjamin A
authors: BA
authors: Kase
authors: Clint M
authors: CM
authors: Cormier
authors: Maged M
authors: MM
authors: Costantine
authors: Maria
authors: M
authors: Hutchinson
authors: Susan M
authors: SM
authors: Ramin
authors: George R
authors: GR
authors: Saade
authors: Manju
authors: M
authors: Monga
authors: Sean C
authors: SC
authors: Blackwell
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult