Evidence map›Paper›PMID 37337693›Full record

ArticlePaediatric and perinatal epidemiology2024

The clinical performance and population health impact of birthweight-for-gestational age indices at term gestation.

Sid John, K S Joseph, John Fahey, Shiliang Liu, Michael S Kramer

Open access · hybridAbstract read
PubMed Publisher
In one paragraph

Article in Paediatric and perinatal epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
4.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Expected and Desirable Preterm and Small Infant Growth Patterns.Advances in nutrition (Bethesda, Md.) · 2024
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Sid JohnDepartment of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada.ORCID 0000-0003-1119-8772
K S JosephDepartment of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada.ORCID 0000-0003-2317-5607
John FaheyReproductive Care Program of Nova Scotia, Halifax, Nova Scotia, Canada.
Shiliang LiuCentre for Surveillance and Applied Research, Public Health Agency of Canada and the School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Michael S KramerDepartments of Epidemiology and Occupation Health and of Pediatrics, McGill University, Montréal, Quebec, Canada.ORCID 0000-0002-5977-8461
University of British Columbia · CAMcGill University · CATechnical University of Nova Scotia · CAUniversity of Ottawa · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe assessment of birthweight for gestational age and the identification of small- and large-for-gestational age (SGA and LGA) infants remain contentious, despite the recent creation of the Intergrowth 21st Project and World Health Organisation (WHO) birthweight-for-gestational age standards.

objectiveWe carried out a study to identify birthweight-for-gestational age cut-offs, and corresponding population-based, Intergrowth 21st and WHO centiles associated with higher risks of adverse neonatal outcomes, and to evaluate their ability to predict serious neonatal morbidity and neonatal mortality (SNMM) at term gestation.

methodsThe study population was based on non-anomalous, singleton live births between 37 and 41 weeks' gestation in the United States from 2003 to 2017. SNMM included 5-min Apgar score <4, neonatal seizures, need for assisted ventilation, and neonatal death. Birthweight-specific SNMM was modelled by gestational week using penalised B-splines. The birthweights at which SNMM odds were minimised (and higher by 10%, 50% and 100%) were estimated, and the corresponding population, Intergrowth 21st, and WHO centiles were identified. The clinical performance and population impact of these cut-offs for predicting SNMM were evaluated.

resultsThe study included 40,179,663 live births and 991,486 SNMM cases. Among female singletons at 39 weeks' gestation, SNMM odds was lowest at 3203 g birthweight, and 10% higher at 2835 g and 3685 g (population centiles 11th and 82nd, Intergrowth centiles 17th and 88th and WHO centiles 15th and 85th). Birthweight cut-offs were poor predictors of SNMM, for example, the cut-offs associated with 10% and 50% higher odds of SNMM among female singletons at 39 weeks' gestation resulted in a sensitivity, specificity, and population attributable fraction of 12.5%, 89.4%, and 2.1%, and 2.9%, 98.4% and 1.3%, respectively.

conclusionsReference- and standard-based birthweight-for-gestational age indices and centiles perform poorly for predicting adverse neonatal outcomes in individual infants, and their associated population impact is also small.

Indexed as

Infant MortalityInfant, Small for Gestational AgeBirth WeightFemaleGestational AgeHumansInfantInfant, NewbornPregnancyPregnancy Trimester, Thirdbirthweightfoetal growthgestational agelarge-for- gestational ageneonatal mortalitysmall-for-gestational age

Identifiers

PMID37337693
OpenAlexW4381308633

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.