Am J Perinatol 2013; 30(07): 565-572
DOI: 10.1055/s-0032-1329188
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Customized versus Population Approach for Evaluation of Fetal Overgrowth

Maged M. Costantine
1   Department of Obstetrics and Gynecology at University of Texas Medical Branch, Galveston, Texas
,
Lisa Mele
2   The George Washington University Biostatistics Center, Washington, DC
,
Mark B. Landon
3   The Ohio State University, Columbus, Ohio
,
Catherine Y. Spong
4   The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Susan M. Ramin
5   The University of Texas Health Science Center at Houston, Houston, Texas
,
Brian Casey
6   The University of Texas Southwestern Medical Center, Dallas, Texas
,
Ronald J. Wapner
7   Columbia University, New York, New York
,
Michael W. Varner
8   University of Utah, Salt Lake City, Utah
,
Dwight J. Rouse
9   University of Alabama at Birmingham, Birmingham, Alabama
,
John M. Thorp Jr.
10   University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Anthony Sciscione
11   Drexel University, Philadelphia, Pennsylvania
,
Patrick Catalano
12   Case Western Reserve University–MetroHealth Medical Center, Cleveland, Ohio
,
Steve N. Caritis
13   University of Pittsburgh, Pittsburgh, Pennsylvania
,
Yoram Sorokin
14   Wayne State University, Detroit, Michigan
,
Alan M. Peaceman
15   Northwestern University, Chicago, Illinois
,
Jorge E. Tolosa
16   Oregon Health & Science University, Portland, Oregon
,
Garland D. Anderson
1   Department of Obstetrics and Gynecology at University of Texas Medical Branch, Galveston, Texas
,
for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland › Author Affiliations
Further Information

Publication History

25 May 2012

19 June 2012

Publication Date:
12 November 2012 (online)

Abstract

Objective To compare the ability of customized versus normalized population fetal growth norms in identifying neonates at risk for adverse perinatal outcomes (APOs) associated with fetal overgrowth and gestational diabetes (GDM).

Study Design Secondary analysis of a multicenter treatment trial of mild GDM. The primary outcome was a composite of neonatal outcomes associated with fetal overgrowth and GDM. Birth weight percentiles were calculated using ethnicity- and gender-specific population and customized norms (Gardosi).

Results Two hundred three (9.8%) and 288 (13.8%) neonates were large for gestational age by population (LGApop) and customized (LGAcust) norms, respectively. Both LGApop and LGAcust were associated with the primary outcome and neonatal hyperinsulinemia, but neither was associated with hypoglycemia or hyperbilirubinemia. The ability of customized and population birth weight percentiles for predicting APOs were poor (area under the receiver operating characteristic curve < 0.6 for six of eight APOs).

Conclusion Neither customized nor normalized population norms better identify neonates at risk of APOs related to fetal overgrowth and GDM.

Notes

Presented in part in Poster Session II (tracking ID 212346, program ID 0382) at the 30th Annual Meeting of the Society of Maternal-Fetal Medicine on February 4, 2010, in Chicago, Illinois.


 
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