A United States National Reference for Fetal Growth : Obstetrics & Gynecology (original) (raw)

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ALEXANDER, GREG R. MPH, ScD; HIMES, JOHN H. PhD, MPH; KAUFMAN, RAJNI B. MPH; MOR, JOANNE MS; KOGAN, MICHAEL PhD

School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; the School of Public Health, University of Minnesota, Minneapolis, Minnesota; the School of Public Health, University of Hawaii, Honolulu, Hawaii; and the National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Servics, Hyattsville, Maryland.

Address reprint requests to: Greg R. Alexander, MPH, ScD, University of Albama at Birmingham School of Public Health, Department of Maternal and Child Health, 112 Mortimer Jordan Hall, 1825 University Boulevard, Birmingham, AL 35294-2010

This work was supported in part by U.S. Department of Health and Human Services, Health Resources and Services Administration, and Maternal and Child Health Bureau grants MCJ-9040 and MCJ-0111.

Received June 29, 1995. Received in revised form September 27, 1995. Accepted October 18, 1995.

Abstract

Objective

To develop a current national fetal growth curve that can be used as a common reference point by researchers to facilitate investigations of the predictors and consequences of small and large for gestational age delivery.

Methods

Single live births to United States resident mothers in 1991 (n = 3,134,879) were used for the development of this curve, which was compared with four previously published fetal growth curves. Techniques were developed to address cases with implausible birth weightgestational age combinations and to smooth fetal growth curves across gestational age categories.

Results

In general, the previously published fetal growth curves underestimated the 1991 United States reference curve. This underestimation is most apparent during the latter weeks of gestation, approximately 33–38 weeks.

Conclusion

Our findings indicate that the prevalence of fetal growth restriction (FGR) will vary markedly, depending on the fetal growth curve used. Furthermore, many previously published fetal growth curves no longer provide an up-to-date reference for describing the distribution of birth weight by gestational age and for determining FGR that is consistent with the most recent live birth data for the entire United States.