Improving the Accuracy of Newborn Weight Classification

Abstract

PurposeThe purpose of this project was to improve the accuracy of newborn weight classification using a regional newborn growth reference (Olsen), an evidence-based method, to determine SGA, AGA and LGA in term infants compared to the current growth reference (Lubchenco). DesignQuality improvement methods using Lewin's Change Theory guided the process. Setting/local problemAt an academic medical center term infants were evaluated for weight-for-gestational age using the Lubchenco growth reference as well as other growth references based on provider preference. PatientsAll term newborns (N = 314) admitted to the newborn nursery during one month following a 3-months implementation of the practice change. Intervention/measurementsNewborn nursery nursing staff and provider staff were provided education and training on using and interpreting the new growth reference. ResultsUse of the Olsen regional growth reference identified more infants as small and fewer infants as large for gestational age. Post hoc analysis with a more global growth reference (Fenton) also identified more infants as small and fewer infants as large for gestational age. There was no statistically significant difference between the Olsen or Fenton growth references. ConclusionUse of either of these two updated growth references more accurately classifies infant weight for gestational age compared to the Lubchenco growth reference, potentially decreasing newborn health risks such as hypoglycemia.