title: Accurate prediction of gestational age using newborn screening analyte data.
abstract: BACKGROUND
  Identification of preterm births and accurate estimates of gestational age for newborn infants is vital to guide care. Unfortunately, in developing countries, it can be challenging to obtain estimates of gestational age. Routinely collected newborn infant screening metabolic analytes vary by gestational age and may be useful to estimate gestational age.
  
  
  OBJECTIVE
  We sought to develop an algorithm that could estimate gestational age at birth that is based on the analytes that are obtained from newborn infant screening.
  
  
  METHODS
  We conducted a population-based cross-sectional study of all live births in the province of Ontario that included 249,700 infants who were born between April 2007 and March 2009 and who underwent newborn infant screening. We used multivariable linear and logistic regression analyses to build a model to predict gestational age using newborn infant screening metabolite measurements and readily available physical characteristics data (birthweight and sex).
  
  
  RESULTS
  The final model of our metabolic gestational dating algorithm had an average deviation between observed and expected gestational age of approximately 1 week, which suggests excellent predictive ability (adjusted R-square of 0.65; root mean square error, 1.06 weeks). Two-thirds of the gestational ages that were predicted by our model were accurate within ±1 week of the actual gestational age. Our logistic regression model was able to discriminate extremely well between term and increasingly premature categories of infants (c-statistic, >0.99).
  
  
  CONCLUSIONS
  Metabolic gestational dating is accurate for the prediction of gestational age and could have value in low resource settings.
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. Electronic address: kwilson@ohri.ca.
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Steven
authors.initials: S
authors.lastname: Hawken
authors.affiliation: Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Newborn Screening Ontario, Ottawa, Ontario, Canada.
authors.forename: Beth K
authors.initials: BK
authors.lastname: Potter
authors.affiliation: Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Newborn Screening Ontario, Ottawa, Ontario, Canada.
authors.forename: Pranesh
authors.initials: P
authors.lastname: Chakraborty
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Walker
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Ducharme
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Little
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000465:Algorithms; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood; D043523:Biotinidase / Q000097:blood; D001724:Birth Weight; D002331:Carnitine / Q000031:analogs & derivatives / Q000097:blood; D003430:Cross-Sectional Studies; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015997:Neonatal Screening; D009864:Ontario; D010084:Oxidation-Reduction; D011247:Pregnancy; D013972:Thyrotropin / Q000097:blood; D005694:UTP-Hexose-1-Phosphate Uridylyltransferase / Q000097:blood
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D005227:Fatty Acids; C116917:acylcarnitine; D019326:17-alpha-Hydroxyprogesterone; D013972:Thyrotropin; D005694:UTP-Hexose-1-Phosphate Uridylyltransferase; D043523:Biotinidase; D002331:Carnitine
keywords: Newborn Screening Ontario; Ontario; algorithm; gestational age; newborn infant screening; preterm birth