Newborn birth weight, length, and head circumference for gestational age in Guangzhou based on the INTERGROWTH-21st standard: a multiyear hospital liveborn cohort study

Abstract

BackgroundWHO's INTERGROWTH-21st Project published an international standard for newborn size using a rigorous method. We aimed to examine the frequency of small and large birth weight, length, and head circumference for gestational age for live births in Guangzhou, China. MethodsData for all singleton live births in 2009–12 were obtained from the Guangzhou Maternal-Fetal Medical Database. The database, maintained by the Key Laboratory for Major Obstetric Diseases of Guangdong, contains information on sex, gestational age (ultrasound-based estimate), birth weight, length, head circumference, diagnoses, and interventions. We classified the newborn infants between 33 and 42 weeks gestation into centile categories according to the international standard. Our study protocol was approved by the medical ethics committee of the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FindingsOf 16 965 singleton live births, 308 (1·8%, 95% CI 1·6–2·0) were below the third centile for their birth weight for gestational age, 808 (4·8%, 4·4–5·1) were below the tenth centile, 1140 (6·7%, 6·3–7·1) were in the 90–97th centile, and 455 (2·7%, 2·4–2·9) were above the 97th centile. For length for gestational age, 422 (2·5%, 95% CI 2·1–2·8) were below the third centile, 696 (4·1%, 3·8–4·5) were in the third to tenth centile, 1603 (9·4%, 8·9–9·9) were in the 90–97th centile, and 628 (3·7%, 3·3–4·1) were above the 97th centile. For head circumference for gestational age, 1940 (11·4%, 95% CI 10·8–12·1) were below the third centile, 2046 (12·1%, 11·5–12·6) were in the third to tenth centile, 849 (5·0%, 4·5–5·4) were in the 90–97th centile, and 510 (3·0%, 2·6–3·4) were above the 97th centile. InterpretationThe birth weight and length for gestational age patterns for newborns in Guangzhou are as expected. The surprisingly high rates of live births below the tenth centile and low rates of live births above the 90th centile of head circumference imply the need to re-assess fetal head growth in the population and to ensure adequate care during pregnancy. FundingMinister of Science and Technology of Guangdong Province.