Individualized sex-specific birth weight percentiles for gestational age based on maternal height and weight

Manfred Voigt; Niels Rochow; Erin Landau-Crangle; Lena Marie Meyer-Kahrweg; Dirk M. Olbertz; Mirjam Kunze; Werner Nikischin; Ursula Wittwer-Backofen; Markus Rochow; Jan Däbritz; Roland Hentschel

doi:10.1515/jpm-2020-0119

Article

Individualized sex-specific birth weight percentiles for gestational age based on maternal height and weight

Manfred Voigt , Niels Rochow , Erin Landau-Crangle , Lena Marie Meyer-Kahrweg , Dirk M. Olbertz , Mirjam Kunze , Werner Nikischin , Ursula Wittwer-Backofen , Markus Rochow , Jan Däbritz and Roland Hentschel

Published/Copyright: August 31, 2020

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From the journal Journal of Perinatal Medicine Volume 49 Issue 1

Abstract

Objectives

The maternal body size affects birth weight. The impact on birth weight percentiles is unknown. The objective of the study was to develop birth weight percentiles based on maternal height and weight.

Methods

This observational study analyzed 2.2 million singletons from the German Perinatal Survey. Data were stratified into 18 maternal height and weight groups. Sex-specific birth weight percentiles were calculated from 31 to 42 weeks and compared to percentiles from the complete dataset using the GAMLSS package for R statistics.

Results

Birth weight percentiles not considering maternal size showed 22% incidence of small for gestational age (SGA) and 2% incidence of large for gestational age (LGA) for the subgroup of newborns from petite mothers, compared to a 4% SGA and 26% LGA newborns from big mothers. The novel percentiles based on 18 groups stratified by maternal height and weight for both sexes showed significant differences between identical original percentiles. The differences were up to almost 800 g between identical percentiles for petite and big mothers. The 97th and 50th percentile from the group of petite mothers almost overlap with the 50th and 3rd percentile from the group of big mothers.

Conclusions

There is a clinically significant difference in birth weight percentiles when stratified by maternal height and weight. It could be hypothesized that birth weight charts stratified by maternal anthropometry could provide higher specificity and more individual prediction of perinatal risks. The new percentiles may be used to evaluate estimated fetal as well as birth weight.

Keywords: customized standards for fetal growth; fetal growth; fetal growth restriction; individualized fetal growth assessment; large for gestational age (LGA); macrosomia; neonate; newborn; nutritional status; small for gestational age (SGA)

Corresponding author: Niels Rochow, MD, PhD, Department of Pediatrics, Paracelsus Medical University, General Hospital, Breslauer Str. 201, 90471Nuremberg, Germany; Department of Pediatrics, Rostock University Medical Center, 18057 Rostock, Germany; and Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada, Phone: +49 (911) 398 118903, Fax: +49 (911) 398 5107, E-mail: rochow@npmmcmaster.ca

Acknowledgments

We thank Tanja Pfitzenmaier for the editorial support.

Research funding: None declared.
Author contributions: MV: Data curation, conceptualization and study design, interpretation of the data; NR: Conceptualization and study design, statistical analysis, interpretation of the data, and wrote the manuscript; EL, LM: Drafted parts of the manuscript; JD, DO, WN, MK, UW: Conceptualization; RH, MR: Interpretation of the data, drafted parts of the manuscript. All co-authors reviewed the manuscript.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was approved by the research ethics board of the University of Rostock (#A 2019-0108).
Data sharing: Detailed percentile values for all maternal weight and height groups can be retrieved from www.growthcalcualtor.org [26].

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Supplementary Material

The online version of this article offers supplementary material https://doi.org/10.1515/jpm-2020-0119.

Received: 2020-03-17

Accepted: 2020-08-04

Published Online: 2020-08-31

Published in Print: 2021-01-26

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Supplementary Material

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Keywords for this article

customized standards for fetal growth; fetal growth; fetal growth restriction; individualized fetal growth assessment; large for gestational age (LGA); macrosomia; neonate; newborn; nutritional status; small for gestational age (SGA)