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Growth charts and prediction of abnormal growth — what is known, what is not known and what is misunderstood
, 1, 1, 1, 1
Affiliations- Department of Reproductive Health, Center of Postgraduate Medical Education, Warsaw, Poland
open access
Abstract
Objectives: Assessment of fetal growth has an important effect on perinatal morbidity and mortality. To understand what tool to choose best for a given population a basic knowledge of how growth charts are developed and used has to be acquired. For this reason, this literature review was performed. Material and methods: An extensive literature review aimed at identifying articles related to the development of growth assessment in both spectrums of abnormal fetal growth — large and small. The analyzed articles were chosen and presented to show both the historical aspects of growth assessment, current trends and future considerations. Results: Identification of both large and small fetuses and neonates is equally crucial. Definitions and methodology vary worldwide and there is an ongoing discussion on the best tool to choose for a given population. An important part of the debate is how to differentiate between the physiologically small fetus and the truly growth restricted fetus who is at risk of perinatal complication. Similarly, the diagnosis of a large fetus is important in prevention of perinatal complications and surgical deliveries. Many clinical settings still lack growth standards. Conclusions: Birthweight for gestational age charts are biased for weight in preterm birth. Prediction and management of outcome cannot be based solely on fetal size. Small is not the only problem, we have to think large as well. A common misunderstanding in clinical practice is not using uniform charts in defining growth.
Abstract
Objectives: Assessment of fetal growth has an important effect on perinatal morbidity and mortality. To understand what tool to choose best for a given population a basic knowledge of how growth charts are developed and used has to be acquired. For this reason, this literature review was performed. Material and methods: An extensive literature review aimed at identifying articles related to the development of growth assessment in both spectrums of abnormal fetal growth — large and small. The analyzed articles were chosen and presented to show both the historical aspects of growth assessment, current trends and future considerations. Results: Identification of both large and small fetuses and neonates is equally crucial. Definitions and methodology vary worldwide and there is an ongoing discussion on the best tool to choose for a given population. An important part of the debate is how to differentiate between the physiologically small fetus and the truly growth restricted fetus who is at risk of perinatal complication. Similarly, the diagnosis of a large fetus is important in prevention of perinatal complications and surgical deliveries. Many clinical settings still lack growth standards. Conclusions: Birthweight for gestational age charts are biased for weight in preterm birth. Prediction and management of outcome cannot be based solely on fetal size. Small is not the only problem, we have to think large as well. A common misunderstanding in clinical practice is not using uniform charts in defining growth.
Keywords
growth charts; small for gestational age; large for gestational age; appropriate for gestational age; growth standard; growth reference
About this articleTitle
Growth charts and prediction of abnormal growth — what is known, what is not known and what is misunderstood
Journal
Issue
Article type
Review paper
Pages
717-721
Published online
2019-12-31
Page views
1878
Article views/downloads
1368
DOI
Pubmed
Bibliographic record
Ginekol Pol 2019;90(12):717-721.
Keywords
growth charts
small for gestational age
large for gestational age
appropriate for gestational age
growth standard
growth reference
Authors
Anna Kajdy
Jan Modzelewski
Krzysztof Herman
Katarzyna Muzyka-Placzynska
Michal Rabijewski
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