Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study

Objective The objective of this study is to evaluate the impact of using International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) (IG-21) growth standards compared with Fenton growth charts on birthweight classification in a multiethnic newborn cohort in Singapore.De...

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Main Authors: Suresh Chandran, Fabian Yap, Daniel Chan, Ruther Teo Zheng, Eirena Beh, Thurston Yan Jia Heng
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/8/1/e002864.full
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author Suresh Chandran
Fabian Yap
Daniel Chan
Ruther Teo Zheng
Eirena Beh
Thurston Yan Jia Heng
author_facet Suresh Chandran
Fabian Yap
Daniel Chan
Ruther Teo Zheng
Eirena Beh
Thurston Yan Jia Heng
author_sort Suresh Chandran
collection DOAJ
description Objective The objective of this study is to evaluate the impact of using International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) (IG-21) growth standards compared with Fenton growth charts on birthweight classification in a multiethnic newborn cohort in Singapore.Design Cross-sectional study.Setting KK Women’s and Children’s Hospital, Singapore.Patients Study population included 2541 babies born between 16 December 2019 and 16 March 2020.Interventions None.Main outcome measures Birthweight classifications of small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) were assessed using IG-21 and Fenton growth charts. The level of agreement between the two charts was measured using Cohen’s kappa coefficient (K).Results Of 2541 neonates, 171 (6.7%) had discordant birthweight classifications. The kappa coefficient indicated moderate overall agreement (K=0.79) between the charts, with decreasing agreement from preterm (K=0.88) to full-term categories (K=0.71). The largest discordance was observed in 98 (60.5%) neonates classified as LGA by IG-21 but AGA by Fenton. In comparison, 60 (2.9%) neonates classified as AGA by IG-21 were SGA by Fenton, while 13 (4.6%) were SGA by IG-21 but AGA by Fenton.Conclusions The study found discrepancies in birthweight classification between IG-21 and Fenton growth charts, with Fenton charts overclassifying SGA and underclassifying LGA in our study population. These findings suggest the potential need to integrate IG-21 growth standards into local practice to improve accuracy in neonatal growth assessment. Further research is necessary to evaluate the clinical implications of these discordant classifications on neonatal outcomes.
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spelling doaj-art-7d9e175079ba4df9874eefde4ce779f62025-08-20T03:49:41ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-11-018110.1136/bmjpo-2024-002864Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional studySuresh Chandran0Fabian Yap1Daniel Chan2Ruther Teo Zheng3Eirena Beh4Thurston Yan Jia Heng5Lee Kong Chian School of Medicine, Nanyang Technological University, SingaporeDuke-NUS Medical School, Singapore2University Hospitals of LeicesterEndocrinology Service, Paediatric Medicine, KK Women`s and Children`s Hospital, SingaporeDepartment of Paediatric Medicine, KK Women`s and Children`s Hospital, SingaporeDepartment of Paediatric Medicine, KK Women`s and Children`s Hospital, SingaporeObjective The objective of this study is to evaluate the impact of using International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) (IG-21) growth standards compared with Fenton growth charts on birthweight classification in a multiethnic newborn cohort in Singapore.Design Cross-sectional study.Setting KK Women’s and Children’s Hospital, Singapore.Patients Study population included 2541 babies born between 16 December 2019 and 16 March 2020.Interventions None.Main outcome measures Birthweight classifications of small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) were assessed using IG-21 and Fenton growth charts. The level of agreement between the two charts was measured using Cohen’s kappa coefficient (K).Results Of 2541 neonates, 171 (6.7%) had discordant birthweight classifications. The kappa coefficient indicated moderate overall agreement (K=0.79) between the charts, with decreasing agreement from preterm (K=0.88) to full-term categories (K=0.71). The largest discordance was observed in 98 (60.5%) neonates classified as LGA by IG-21 but AGA by Fenton. In comparison, 60 (2.9%) neonates classified as AGA by IG-21 were SGA by Fenton, while 13 (4.6%) were SGA by IG-21 but AGA by Fenton.Conclusions The study found discrepancies in birthweight classification between IG-21 and Fenton growth charts, with Fenton charts overclassifying SGA and underclassifying LGA in our study population. These findings suggest the potential need to integrate IG-21 growth standards into local practice to improve accuracy in neonatal growth assessment. Further research is necessary to evaluate the clinical implications of these discordant classifications on neonatal outcomes.https://bmjpaedsopen.bmj.com/content/8/1/e002864.full
spellingShingle Suresh Chandran
Fabian Yap
Daniel Chan
Ruther Teo Zheng
Eirena Beh
Thurston Yan Jia Heng
Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
BMJ Paediatrics Open
title Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
title_full Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
title_fullStr Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
title_full_unstemmed Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
title_short Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study
title_sort comparative analysis of intergrowth 21st and fenton growth charts for birthweight classification in a multiethnic asian cohort a cross sectional study
url https://bmjpaedsopen.bmj.com/content/8/1/e002864.full
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