title: Comparison of customized and cohort-based birthweight standards in identification of growth-restricted infants in GUSTO cohort study.
abstract: BACKGROUND
  The aim was to evaluate the ability of customized and cohort birthweight standards in discriminating intrauterine growth retardation (IUGR).
  
  
  METHODS
  Birthweights (BWs) of GUSTO singleton infants born at gestational age (GA) 35-41 weeks were converted using two standards: (a) GUSTO cohort-based BW centile adjusted for GA and baby gender; (b) customized BW percentile calculator adjusted for maternal height and weight, race, parity, GA and gender. Infants were classified into three groups: (1) < 10th BW centile by customization- customized-SGA, (2) < 10th BW centile by GUSTO- GUSTO-SGA; and (3) > 10th BW centile by both standards - BOTH-non-SGA.
  
  
  RESULTS
  Of the 1011 infant-mother dyads, 68 were customized-SGA and 104 were GUSTO-SGA, with concordance of 61% (n = 63) for SGA. While 5 (7%) of customized-SGA were not SGA by GUSTO-charts, 41 (39%) of GUSTO-SGA were not SGA by customized-charts. Customized-SGA had significantly the least growth in abdominal circumference (AC) and highest head circumference (HC): AC growth ratio between second and third trimester; and the lowest mean BW, ponderal index and placental weight than other groups.
  
  
  CONCLUSIONS
  Customized-SGA standard was a better discriminator of pathologic fetal growth based on AC growth. It improved strength of association with pathology and in our population reduced false positives (41/104 = 39%) in the assessment of SGA.
authors.affiliation: a Department of Neonatology .
authors.forename: Pratibha
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: a Department of Neonatology .
authors.forename: Victor Samuel
authors.initials: VS
authors.lastname: Rajadurai
authors.affiliation: b Department of Paediatrics , and.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: c Department of Maternal Fetal Medicine , KK Women's and Children's Hospital, Singapore .
authors.forename: George
authors.initials: G
authors.lastname: Yeo
authors.affiliation: d Department of Obstetrics & Gynaecologyl , and.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: c Department of Maternal Fetal Medicine , KK Women's and Children's Hospital, Singapore .
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: e Saw Swee Hock School of Public Health, National University of Singapore , Singapore .
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: f The Liggins Institute, University of Auckland , New Zealand .
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: g Department of Paediatrics , National University of Singapore , Singapore , and.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: c Department of Maternal Fetal Medicine , KK Women's and Children's Hospital, Singapore .|h Duke-NUS Graduate Medical School , Singapore.
authors.forename: Kok Hian
authors.initials: KH
authors.lastname: Tan
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D011247:Pregnancy; D012015:Reference Standards; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055105:Waist Circumference
keywords: Abdominal circumference; customized birthweight centiles; intra uterine growth restriction; small for gestational age