Country-Specific Tool Predicts Adverse Perinatal Outcomes
Disparities affected by language and cultural barriers, socioeconomic status, insurance status
MONDAY, May 30 (HealthDay News) -- A new generic reference tool is better at predicting low fetal weight and adverse perinatal outcomes among global populations, according to a study published in the May 28 issue of The Lancet.
Rafael T. Mikolajczyk, M.D., from the Bremen Institute for Prevention Research and Social Medicine in Germany, and colleagues created a generic reference for fetal weight and birth weight that can easily be adjusted to local populations. Based on Hadlock's fetal weight reference and the idea of proportionality proposed by Gardosi, the reference was made easily adjustable for any local population according to the mean birth weight at 40 weeks of gestation. Data from the 2004 to 2008 World Health Organization Global Survey on Maternal and Perinatal Health, involving 237,025 births from 24 countries, were used to validate the tool. The risk of adverse perinatal outcomes for infants who were small for gestational age was estimated by the new tool, and compared with those identified by Hadlock (non-customized) and Gardosi (individualized).
The investigators found that, compared to infants who were not small for gestational age, the odds ratio of adverse outcomes for infants who were small for gestational age was 1.59 for the non-customized fetal weight reference, 2.87 for the newly developed country-specific reference, and 2.84 for the fully individualized reference.
"Our generic reference for fetal weight and birth weight percentiles can be easily adapted to local populations. It has a better ability to predict adverse perinatal outcomes than has the non-customized fetal weight reference, and is simpler to use than the individualized reference without loss of predictive ability," the authors write.