Original ResearchObstetricsFrom population reference to national standard: new and improved birthweight charts
Section snippets
Procedures
Data were extracted from the Dutch perinatal database, which is a linked database of medical registries from the 4 professional organizations that provide perinatal care in The Netherlands: the NVOG, KNOV, NVK and the National Association of General Practitioners (LHV).11 Registration of obstetric data starts at the first antenatal visit; the neonatal registry contains data only on neonates who were hospitalized following delivery.12 In over 95% of pregnancies, gestational age is certain,
Results
Between 2000 and 2014, a total of 2.7 million infants were born in The Netherlands. We excluded 112,661 infants (4.2%) because of missing data, fetal death, or gestational age not between 23 and 42 weeks (Figure 1). To obtain a low-risk population, another 969,552 infants (37.3%) were excluded because of the presence of 1 or more risk factors.
Figure 2 shows the differences in mean birthweight between infants with risk factors vs infants without. From 31 weeks’ gestation onward, twins and
Comment
This article describes the development of prescriptive birthweight charts, derived from a large population of Dutch infants without risk factors for SGA or excessive fetal growth.
Numerous authors in many countries have put a great deal of thought into the desired properties of birthweight charts. Despite extensive literature on the subject, there is little evidence to support a particular approach. Sources of controversy include the choice of infants who should be included in a population and
Acknowledgments
This research was supported by the Isala Science and Innovation Fund and Nutricia Early Life Nutrition. The sponsors had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, or in the preparation, review, approval of the manuscript, or decision to submit the manuscript for publication.
We thank our collaborators from the Working Group Reference Charts who provided insight and expertise that greatly assisted the research:
Dr J. van
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Dr Hukkelhoven is currently at Wageningen University and Research, Wageningen Data Competence Center, Wageningen, The Netherlands.
The authors report no conflict of interest.
This work was supported by unrestricted research grants from Nutricia Early Life Nutrition and the Isala Innovation and Science Fund.
Cite this article as: Hoftiezer L, Hof MHP, Dijs-Elsinga J, et al. From population reference to national standard: new and improved birthweight charts. Am J Obstet Gynecol 2019;220:383.e1-17.