Abstract
Since classification of infants at birth into proper intra-uterine (IU) growth categories is vital for risk assessment, we tested whether the widely used Colorado (C) standards, (Lubchenco et al, 1963) which were based on a small sample of 5635 white infants (18% premature), would be appropriate to classify today's urban infant population of mixed ethnicity. Data from 32,076 singleton liveborn infants born in 13 University of Illinois (UI) network hospitals between 1982–83 were analysed. 51% of infants were white, 25% black and 19% hispanics. 2075 infants were ≤ 36 weeks.
RESULTS: For all gestational ages between 32–42 weeks, the 10th, 50th and 90th percentile (PC) weights from UI data were 2-28% higher than the C standards. (P<0.0001). Frequency of our infants who would be classed into SGA, (<10th PC) and LGA (>90th PC) groups using both standards are in the table.
Since C weights were lower at all gestations, C standards under-counted SGA frequency and over-counted the LGA frequency in our population. Thus with C standards 5100 infants (16% of total) were classified into wrong intra-uterine growth categories. A spectrum of morbidity risk analysis (Apgar score, Mat. Diabetes etc) in these infants suggest that all our infants should be classified using UI standards rather than C standards. We conclude that regional IU growth standards must be developed for proper classification of infants at birth.
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Raju, T., Miller, S. & Vidyasagar, D. 1490 UPDATING INTRAUTERINE GROWTH CURVES. Pediatr Res 19, 359 (1985). https://doi.org/10.1203/00006450-198504000-01514
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DOI: https://doi.org/10.1203/00006450-198504000-01514