title: Should we use customized fetal growth percentiles in urban Canada?
abstract: An increasingly common challenge in antenatal care of the small for gestational age (SGA) fetus is the distinction between the constitutionally (physiologically) small fetus and the fetus affected by pathological intrauterine growth restriction (IUGR). We discuss here the rationale and the evidence for the use of customized growth percentiles for the purpose of distinguishing between the fetus with true IUGR and the fetus with constitutional SGA. We also provide estimates of the potential effects of adopting ethnicity-specific birth weight curves on the rates of SGA and large for gestational age status in multi-ethnic metropolitan cities in North America and Europe, such as the City of Toronto. Using customized growth percentiles would result in a considerable decline in the rate of a false-positive diagnosis of SGA among visible minorities, and improve the detection rate of true large for gestational age fetuses among these groups.
authors: Maternal-Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto ON.
authors: Nir
authors: N
authors: Melamed
authors: Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Toronto ON.
authors: Joel G
authors: JG
authors: Ray
authors: Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto ON.
authors: Prakesh S
authors: PS
authors: Shah
authors: Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Toronto ON.
authors: Howard
authors: H
authors: Berger
authors: Maternal-Fetal Medicine Division (Placenta Clinic), Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto ON.
authors: John C
authors: JC
authors: Kingdom
mesh_terms: D001724:Birth Weight; D002170:Canada; D005006:Ethnicity; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D020567:Fetal Weight / Q000208:ethnology; D005865:Gestational Age; D006801:Humans; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D012016:Reference Values; D014505:Urban Population
keywords: customized; growth; percentiles