title: Implementing the INTERGROWTH-21stfetal growth standards in France: a 'flash study' of the College Français d'Echographie Foetale (CFEF).
abstract: OBJECTIVE
  To assess potential differences in fetal size between the French population and the international population from the INTERGROWTH-21st(IG-21st) Project and to measure the impact of switching to the IG-21streference standards for fetal size.
  
  
  METHODS
  This was a nationwide cross-sectional study of fetal ultrasound biometry. Low-risk singleton pregnancies were recruited prospectively within the network of the national French College of Fetal Ultrasound, CFEF, over a 6-week period. Further selection was performed based on the criteria of the IG-21stProject in order to obtain a comparable population. Head circumference (HC) was used as the main fat-free skeletal measure of growth for comparison of French fetal size with that of the IG-21stpopulation. The impact of switching to the IG-21stfetal growth standards was quantified by comparing Z-scores calculated using the IG-21ststandards with those calculated using locally derived reference ranges for HC, abdominal circumference (AC) and femur length (FL).
  
  
  RESULTS
  Following selection, 4858 cases were analyzed. The distribution of HC demonstrated clear similarity between our French population and the IG-21stpopulation: our observed centile curves closely matched those of IG-21stand the Z-scores were close to 0 across gestational age. The IG-21ststandards performed as well as did locally derived charts in terms of screening for small-for-gestational age by AC, while they identified significantly fewer small FL values than were expected and than did the locally derived charts.
  
  
  CONCLUSIONS
  Under strict selection criteria, fetal size in France is similar to that of the international population used in the IG-21stProject. The discrepancies in FL are unlikely to impact on prenatal management. Therefore, switching from locally derived reference ranges to the IG-21ststandards appears to be a safe option. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
authors: Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France.|EA FETUS, 7328, Université Paris-Descartes, Paris, France.
authors: J J
authors: JJ
authors: Stirnemann
authors: Collège Français d'Echographie Foetale, CFEF, France.
authors: N
authors: N
authors: Fries
authors: Collège Français d'Echographie Foetale, CFEF, France.
authors: R
authors: R
authors: Bessis
authors: Collège Français d'Echographie Foetale, CFEF, France.
authors: M
authors: M
authors: Fontanges
authors: Collège Français d'Echographie Foetale, CFEF, France.
authors: R
authors: R
authors: Mangione
authors: Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France.|EA FETUS, 7328, Université Paris-Descartes, Paris, France.|Collège Français d'Echographie Foetale, CFEF, France.
authors: L J
authors: LJ
authors: Salomon
mesh_terms: D049628:Body Size; D002508:Cephalometry; D003430:Cross-Sectional Studies; D005260:Female; D047109:Fetal Development; D005602:France; D005865:Gestational Age; D057238:Growth Charts; D006257:Head / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000592:standards*
keywords: biometry; congenital abnormalities; cross-sectional studies; epidemiology; fetal development; growth charts; pregnancy; ultrasound