Abstract
Background: Different gestational age specific birthweight reference charts have been produced for different populations and ethnic groups over different time periods, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese and international data. Methods: All singleton Chinese livebirths delivered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts. Results: A total of 25,508 livebirths between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ranges differed significantly, so that the proportion of babies that would be classified as SGA or LGA varied widely using cut-offs from different studies. Older local studies tend to under-estimate, while the international growth charts would over-estimate the proportion of SGA babies. Conclusions: Updating fetal growth curve references based on local data is essential to establish more precise definitions of SGA and LGA babies in clinical management. The use of international growth charts in our population may not be appropriate and requires further validation.
Highlights
Birthweight is an important marker to reflect the intrauterine growth environment of neonates as well as a critical determining factor of perinatal morbidity and mortality, and has implications for both short as well as long term outcome of these babies
The birthweight data of a total of 25,508 singleton livebirths delivered in the United Christian Hospital (UCH) between 24 completed weeks and 42 completed weeks of gestation within the 6-year study period from 2012 to 2017 were used to construct the gestational age specific smoothed birthweight centiles
As the sample size of livebirths delivered at or before 24 weeks was too small for reliable estimation of weight centiles, these were not included for the final analysis
Summary
Birthweight is an important marker to reflect the intrauterine growth environment of neonates as well as a critical determining factor of perinatal morbidity and mortality, and has implications for both short as well as long term outcome of these babies. Fetal growth was known to vary with ethnicity, and ethnicity specific birthweight distributions were shown to predict neonatal morbidity better than the population-based birthweight [7] [8] [9]. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of small and large for gestational age (SGA and LGA). The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ranges differed significantly, so that the proportion of babies that would be classified as SGA or LGA varied widely using cut-offs from different studies
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