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Customized versus Population Approach for Evaluation of Fetal Overgrowth

Citation

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

Abstract

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.

URL

http://dx.doi.org/10.1055/s-0032-1329188

Reference Type

Journal Article

Year Published

2013

Journal Title

American Journal of Perinatology

Author(s)

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

PMCID

PMC3657303