title: Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women.
abstract: BACKGROUND
  Fetal growth restriction is defined as failure to reach growth potential and considered one of the major complications of pregnancy. These infants are often, although not universally, small for gestational age (SGA). SGA is defined as a weight less than a specified percentile (usually the 10th percentile). Identification of SGA infants is important because these infants are at increased risk of perinatal morbidity and mortality. Screening for SGA is a challenge for all maternity care providers and current methods of clinical assessment fail to detect many infants that are SGA. Large observational studies suggest that customised growth charts may be better able to differentiate between constitutional and pathologic smallness. Customised charts adjust for physiological variables such as maternal weight and height, ethnicity and parity.
  
  
  OBJECTIVE
  To assess the benefits and harms of using population-based growth charts compared with customised growth charts as a screening tool for detection of fetal growth in pregnant women.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011), reviewed published guidelines and searched the reference lists of review articles.
  
  
  METHODS
  Randomised, quasi-randomised or cluster randomised clinical trials comparing customised versus population-based growth charts used as a screening tool for detection of fetal growth in pregnant women.
  
  
  METHODS
  Two review authors independently assessed trials for inclusion.
  
  
  RESULTS
  No randomised trials met the inclusion criteria.
  
  
  CONCLUSIONS
  There is no randomised trial evidence currently available. Further randomised trials are required to accurately assess whether the improvement in detection shown is secondary to customised charts alone or an effect of the policy change. Future research in large trials is needed to investigate the benefits and harms (including perinatal mortality) of using customised growth charts in different settings and for both fundal height and ultrasound measurements.
authors.affiliation: RPA Newborn Care, RPA Women and Babies, Royal Prince Alfred Hospital and University of Sydney, School of Public Health, Missenden Road, Camperdown, Sydney, Australia, NSW 2050.
authors.forename: Angela E
authors.initials: AE
authors.lastname: Carberry
authors.forename: Adrienne
authors.initials: A
authors.lastname: Gordon
authors.forename: Diana M
authors.initials: DM
authors.lastname: Bond
authors.forename: Jon
authors.initials: J
authors.lastname: Hyett
authors.forename: Camille H
authors.initials: CH
authors.lastname: Raynes-Greenow
authors.forename: Heather E
authors.initials: HE
authors.lastname: Jeffery
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D057238:Growth Charts; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy