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Customized versus Population Approach for Evaluation of Fetal Overgrowth


Costantine, Maged M.; Mele, Lisa; Landon, Mark B.; Spong, Catherine Y.; Ramin, Susan M.; Casey, Brian M.; Wapner, Ronald J.; Varner, Michael W.; Rouse, Dwight J.; & Thorp, John M., Jr., et al. (2013). Customized versus Population Approach for Evaluation of Fetal Overgrowth. American Journal of Perinatology, 30(7), 565-571. PMCID: PMC3657303


OBJECTIVE: To compare the ability of customized versus normalized population fetal growth norms in identifying neonates at risk for adverse perinatal outcomes (APOs) associated with fetal overgrowth and gestational diabetes (GDM).
STUDY DESIGN: Secondary analysis of a multicenter treatment trial of mild GDM. The primary outcome was a composite of neonatal outcomes associated with fetal overgrowth and GDM. Birth weight percentiles were calculated using ethnicity- and gender-specific population and customized norms (Gardosi).
RESULTS: Two hundred three (9.8%) and 288 (13.8%) neonates were large for gestational age by population (LGApop) and customized (LGAcust) norms, respectively. Both LGApop and LGAcust were associated with the primary outcome and neonatal hyperinsulinemia, but neither was associated with hypoglycemia or hyperbilirubinemia. The ability of customized and population birth weight percentiles for predicting APOs were poor (area under the receiver operating characteristic curve < 0.6 for six of eight APOs).
CONCLUSION: Neither customized nor normalized population norms better identify neonates at risk of APOs related to fetal overgrowth and GDM.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Perinatology


Costantine, Maged M.
Mele, Lisa
Landon, Mark B.
Spong, Catherine Y.
Ramin, Susan M.
Casey, Brian M.
Wapner, Ronald J.
Varner, Michael W.
Rouse, Dwight J.
Thorp, John M., Jr.
Sciscione, Anthony C.
Catalano, Patrick M.
Caritis, Steve N.
Sorokin, Yoram
Peaceman, Alan M.
Tolosa, Jorge E.
Anderson, Garland D., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network