The Danish newborn standard and the International Fetal and Newborn Growth Consortium for the 21st Century newborn standard: a nationwide register-based cohort study

Ditte N. Hansen*, Henriette S. Kahr, Christian Torp-Pedersen, Jan Feifel, Niels Uldbjerg, Marianne Sinding, Anne Sørensen

*Corresponding author for this work

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Abstract

Background: It is a matter of debate whether 1 universal standard, such as the International Fetal and Newborn Growth Consortium for the 21st Century standard, can be applied to all populations.

Objective: The primary objective was to establish a Danish newborn standard based on the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century standard to compare the percentiles of these 2 standards. A secondary objective was to compare the prevalence and risk of fetal and neonatal deaths related to small for gestational age defined by the 2 standards when used in the Danish reference population.

Study design: This was a register-based nationwide cohort study. The Danish reference population included 375,318 singletons born at 33 to 42 weeks of gestation in Denmark between January 1, 2008, and December 31, 2015. The Danish standard cohort included 37,811 newborns who fulfilled the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century standard. Birthweight percentiles were estimated using smoothed quantiles for each gestational week. The outcomes included birthweight percentiles, small for gestational age (defined as a birthweight of 3rd percentile), and adverse outcomes (defined as either fetal or neonatal death).

Results: At all gestational ages, the Danish standard median birthweights at term were higher than the International Fetal and Newborn Growth Consortium for the 21st Century standard median birthweights: 295g for females and 320 g for males. Therefore, the estimates of the prevalence rate of small for gestational age within the entire population were different: 3.9% (n=14,698) using the Danish standard vs 0.7% (n=2640) using the International Fetal and Newborn Growth Consortium for the 21st Century standard. Accordingly, the relative risk of fetal and neonatal deaths among small-for-gestational-age fetuses differed by SGA status defined by the different standards (4.4 [Danish standard] vs 9.6 [International Fetal and Newborn Growth Consortium for the 21st Century standard]).

Conclusion: Our finding did not support the hypothesis that 1 universal standard birthweight curve can be applied to all populations.
Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume229
Issue number3
Pages (from-to)290.e1-290.e8
Number of pages8
ISSN0002-9378
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Keywords

  • International Fetal and Newborn Growth Consortium for the 21st Century
  • birthweight
  • fetal death
  • fetal growth restriction
  • neonatal death
  • obstetrical ultrasound
  • register
  • small for gestational age
  • standard

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