CUSTOMISED FETAL GROWTH CHARTS VERSUS POPULATION-BASED GROWTH CHARTS IN IDENTIFYING ADVERSE FETAL OUTCOMES: A SYSTEMATIC REVIEW

Abstract

One for all antenatal growth charts may not adequately capture risks for adverse fetal outcomes. This review appraises studies on customised growth curves in preventing adverse fetal effects and compares them with population-based growth charts. A review was done on articles published in PubMed database, Cochrane database and Google Scholar. The search criteria were English written described fetal outcomes using a customised fetal growth chart published between 2007 and 2020. All selected articles reported antenatal follow-up data and compared the intervention using the customised antenatal growth chart to the population-based antenatal growth chart. The primary outcome measure was the incidence of small for gestational age (SGA) and stillbirths. The feasibility of using a customised fetal growth chart versus a population-based fetal growth chart was assessed as the process indicator. Twenty-two articles comparing the use of customised growth charts to population-based growth charts were found. Sixteen studies depicted a significant improvement in the detection of pathological SGA over a population-based growth chart ,and another two studies showed significant in detecting large gestational age (LGA). In conclusion, the customised growth charts improve the detection of pathological SGA antenatally. The feasibility of the intervention depends on the training, policy, infrastructure, staffing, awareness and ethics. A summarised framework analysis for implementing customised growth charts is proposed for future research.