title: Identification of small for gestational age by population-based and customized growth charts in newborns of obese and normal-weight primiparous women.
abstract: OBJECTIVE
  Our hypothesis was that newborns of obese mothers would be more likely to be classified as small for gestational age (SGA) by their customized growth curves than by the standard growth curves when compared to newborns of normal-weight mothers.
  
  
  METHODS
  This is a retrospective cohort of primiparous patients delivering between 1 July 2008 and 30 June 2012. Normal-weight was defined as BMI ≤25 kg/m(2) and obese as BMI ≥ 30 kg/m(2). Infant birth-weight was characterized as SGA or non-SGA from the Lubchenco curve, the Fenton Preterm Growth Chart, and the customized growth curve.
  
  
  RESULTS
  Infants were more likely to be classified as SGA on the customized curve compared with Lubchenco curve. Odds ratio was 2.8 (CI: 1.7-4.4; p = 0.001) for obese women and was 2.9 (CI: 1.7-5.1; p < 0.001) for normal-weight women. Infants were also more likely to be classified as SGA based on the customized curve compared with the Fenton Preterm Growth Curve. The odds ratio was 2.3 (CI: 1.4-3.8; p = 0.001) for obese women and was 1.5 (CI: 1.01-2.33; p = 0.04) for normal-weight women.
  
  
  CONCLUSIONS
  Population-based curves may mask SGA in obese women. Our study demonstrates that customized growth curves identify more SGA than population-based growth curves in obese and normal-weight women.
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Maternal Fetal Medicine, Penn State Milton S. Hershey Medical Center , Hershey , PA , USA .
authors.forename: Julianne R
authors.initials: JR
authors.lastname: Lauring
authors.affiliation: b Department of Obstetrics and Gynecology , Penn State Milton S. Hershey Medical Center , Hershey , PA , USA , and.
authors.forename: Megha
authors.initials: M
authors.lastname: Gupta
authors.affiliation: c Department of Public Health Sciences , Penn State, Milton S. Hershey Medical Center , Hershey , PA , USA.
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Maternal Fetal Medicine, Penn State Milton S. Hershey Medical Center , Hershey , PA , USA .
authors.forename: John T
authors.initials: JT
authors.lastname: Repke
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Maternal Fetal Medicine, Penn State Milton S. Hershey Medical Center , Hershey , PA , USA .
authors.forename: Jaimey M
authors.initials: JM
authors.lastname: Pauli
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D005260:Female; D047109:Fetal Development; D005865:Gestational Age; D057238:Growth Charts; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D009765:Obesity; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D055815:Young Adult
keywords: Customized growth charts; estimated fetal weight; fetal growth restriction; obesity; small for gestational age