• Cochrane Db Syst Rev · May 2014

    Review

    Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women.

    • Angela E Carberry, Adrienne Gordon, Diana M Bond, Jon Hyett, Camille H Raynes-Greenow, and Heather E Jeffery.
    • Sydney School of Public Health, University of Sydney, Camperdown, Sydney, NSW, Australia, 2050.
    • Cochrane Db Syst Rev. 2014 May 16; 2014 (5): CD008549CD008549.

    BackgroundFetal growth restriction is defined as failure to reach growth potential and considered one of the major complications of pregnancy. These infants are often, although not universally, small for gestational age (SGA). SGA is defined as a weight less than a specified percentile (usually the 10th percentile). Identification of SGA infants is important because these infants are at increased risk of perinatal morbidity and mortality. Screening for SGA is a challenge for all maternity care providers and current methods of clinical assessment fail to detect many infants who are SGA. Large observational studies suggest that customised growth charts may be better able to differentiate between constitutional and pathologic smallness. Customised charts adjust for physiological variables such as maternal weight and height, ethnicity and parity.ObjectivesTo assess the benefits and harms of using population-based growth charts compared with customised growth charts as a screening tool for detection of fetal growth in pregnant women.Search MethodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (12 March 2014), reviewed published guidelines and searched the reference lists of review articles.Selection CriteriaRandomised, quasi-randomised or cluster-randomised clinical trials comparing customised versus population-based growth charts used as a screening tool for detection of fetal growth in pregnant women.Data Collection And AnalysisTwo review authors independently assessed trials for inclusion.Main ResultsNo randomised trials met the inclusion criteria.Authors' ConclusionsThere is no randomised trial evidence currently available. Further randomised trials are required to accurately assess whether the improvement in detection shown is secondary to customised charts alone or an effect of the policy change. Future research in large trials is needed to investigate the benefits and harms (including perinatal mortality) of using customised growth charts in different settings and for both fundal height and ultrasound measurements.

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