Implications of diagnosis of small for gestational age fetuses using European and Asian growth charts

Abstract

Diagnosis of IUGR/ SGA has considerable impact on the mother, the care giver and the health system since it is associated with increased prenatal morbidity and mortality and poor pregnancy outcome. It was known for decades that there were differences in fetal size among different populations and it was established that South Asian fetuses were 2SD smaller in their estimated weight than European fetuses. Despite this fact due to non availability of own growth charts we tend to use European growth charts for the diagnosis of IUGR/SGA. Therefore this study was designed do identify the implications on pregnancy and neonatal outcomes using Asian and European growth charts. In this study the birth weight was considered for the diagnosis of IUGR/SGA using Bangladeshi growth chart and a European growth chart, but it has its antenatal implications since ultra sound estimation of fetal weight has good accuracy. According to the POG and Birth weight, three groups were identified. Group I-IUGR/SGA according to Bangladeshi growth chart, Group 2- IUGR/SGA according to European growth chart but not having IUGRISGA according to Bangladeshi growth chart, Group 3-No IUGR/SGA according to both charts. The prevalence of SGA/[UGR according to Bangladeshi growth chart was 12.7 percent (95percent CI 10.9-14.5) and prevalence of that according to European growth chart was 51.7percent (95 percent CI 47.9-55.4). There were statistically significant higher rates in IUD (PO.OO I) and neonatal hypoglycaemia (PO.OO I), in group I compared with group 2 and 3 considered together