Prevalence of small-for-gestational age and its mortality risk varies by choice of birth-weight-for-gestation reference population

Authors

Joanne D. Katz, Johns Hopkins UniversityFollow
Lauren A. Wu, Johns Hopkins University
Luke C. Mullany, Johns Hopkins University
Christian L. Coles, Johns Hopkins University
Anne C.C. Lee, Brigham and Women's Hospital, Boston, MAFollow
Naoko Kozuki, Johns Hopkins University
James M. Tielsch, George Washington UniversityFollow

Document Type

Journal Article

Publication Date

3-18-2014

Journal

PLoS ONE

Volume

Volume 9, Issue 3

Inclusive Pages

Article number e92074

Keywords

Birth Weight; Female; Gestational Age; Humans; Income; India--epidemiology; Infant; Infant Mortality--ethnology; Infant, Newborn; Infant, Premature; Infant, Small for Gestational Age; Male; Nepal--epidemiology; Prevalence; Reference Values; Risk; Rural Population; Sex Factors

Abstract

Background

We use data from rural Nepal and South India to compare the prevalence of small-for-gestational-age (SGA) and neonatal mortality risk associated with SGA using different birth-weight-for-gestation reference populations.

Methods

We identified 46 reference populations in low-, middle-, and high-income countries, of which 26 met the inclusion criteria of being commonly cited and having numeric 10th percentile cut points published. Those reference populations were then applied to populations from two community-based studies to determine SGA prevalence and its relative risk of neonatal mortality.

Results

The prevalence of SGA ranged from 10.5% to 72.5% in Nepal, and 12.0% to 78.4% in India, depending on the reference population. Females had higher rates of SGA than males using reference populations that were not sex specific. SGA prevalence was lowest when using reference populations from low-income countries. Infants who were both preterm and SGA had much higher mortality risk than those who were term and appropriate-for-gestational-age. Risk ratios for those who are both preterm and SGA ranged from 7.34–17.98 in Nepal and 5.29–11.98 in India, depending on the reference population.

Conclusions

These results demonstrate the value of a common birth-weight-for-gestation reference population that will facilitate comparisons of SGA prevalence and mortality risk across research studies.

Comments

Reproduced with permission of PLoS ONE.

Creative Commons License

This work is licensed under a Creative Commons Attribution 3.0 License.

APA Citation

Katz, J., Wu, L.A., Mullany, L.C., Coles, C.L., Lee, A.C.C., et al. (2014). Prevalence of small-for-gestational age and its mortality risk varies by choice of birth-weight-for-gestation reference population. PLoS ONE, 9(3):e92074.

Peer Reviewed

1

Open Access

1