Customized versus Population Approach for Evaluation of Fetal Overgrowth

Maged M. Costantine; Lisa Mele; Mark B. Landon; Catherine Y. Spong; Susan M. Ramin; Brian Casey; Ronald J. Wapner; Michael W. Varner; Dwight J. Rouse; John M. Thorp Jr.; Anthony Sciscione; Patrick Catalano; Steve N. Caritis; Yoram Sorokin; Alan M. Peaceman; Jorge E. Tolosa; Garland D. Anderson; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland

doi:10.1055/s-0032-1329188

American Journal of Perinatology, Table of Contents

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

¹Department of Obstetrics and Gynecology at University of Texas Medical Branch, Galveston, Texas

,

Lisa Mele

²The George Washington University Biostatistics Center, Washington, DC

,

Mark B. Landon

³The Ohio State University, Columbus, Ohio

,

Catherine Y. Spong

⁴The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

,

Susan M. Ramin

⁵The University of Texas Health Science Center at Houston, Houston, Texas

,

Brian Casey

⁶The University of Texas Southwestern Medical Center, Dallas, Texas

,

Ronald J. Wapner

⁷Columbia University, New York, New York

,

Michael W. Varner

⁸University of Utah, Salt Lake City, Utah

,

Dwight J. Rouse

⁹University of Alabama at Birmingham, Birmingham, Alabama

,

John M. Thorp Jr.

¹⁰University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

,

Anthony Sciscione

¹¹Drexel University, Philadelphia, Pennsylvania

,

Patrick Catalano

¹²Case Western Reserve University–MetroHealth Medical Center, Cleveland, Ohio

,

Steve N. Caritis

¹³University of Pittsburgh, Pittsburgh, Pennsylvania

,

Yoram Sorokin

¹⁴Wayne State University, Detroit, Michigan

,

Alan M. Peaceman

¹⁵Northwestern University, Chicago, Illinois

,

Jorge E. Tolosa

¹⁶Oregon Health & Science University, Portland, Oregon

,

Garland D. Anderson

¹Department 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

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.

Keywords

customized growth - adverse neonatal outcomes - gestational diabetes - large for gestational age

Full Text

References

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