Please use this identifier to cite or link to this item: https://doi.org/10.1186/1471-2393-8-1
Title: Does one size fit all? The case for ethnic-specific standards of fetal growth.
Authors: Kierans, W.J
Joseph, K.S
Luo, Z.C
Platt, R
Wilkins, R
Kramer, M.S 
Keywords: American Indian
article
Asia
birth weight
Canada
ethnic group
ethnology
female
fetus development
gestational age
human
infant mortality
male
newborn
perinatology
physiology
small for date infant
standard
statistics
Asia
Birth Weight
British Columbia
Canada
Ethnic Groups
Female
Fetal Development
Gestational Age
Humans
Indians, North American
Infant Mortality
Infant, Newborn
Infant, Small for Gestational Age
Male
Perinatology
Issue Date: 2008
Citation: Kierans, W.J, Joseph, K.S, Luo, Z.C, Platt, R, Wilkins, R, Kramer, M.S (2008). Does one size fit all? The case for ethnic-specific standards of fetal growth.. BMC pregnancy and childbirth 8 : 1. ScholarBank@NUS Repository. https://doi.org/10.1186/1471-2393-8-1
Rights: Attribution 4.0 International
Abstract: BACKGROUND: Birth weight for gestational age is a widely-used proxy for fetal growth. Although the need for different standards for males and females is generally acknowledged, the physiologic vs pathologic nature of ethnic differences in fetal growth is hotly debated and remains unresolved. METHODS: We used all stillbirth, live birth, and deterministically linked infant deaths in British Columbia from 1981 to 2000 to examine fetal growth and perinatal mortality in Chinese (n = 40,092), South Asian (n = 38,670), First Nations, i.e., North American Indian (n = 56,097), and other (n = 731,109) births. We used a new analytic approach based on total fetuses at risk to compare the four ethnic groups in perinatal mortality, mean birth weight, and "revealed" (< 10th percentile) small-for-gestational age (SGA) among live births based on both a single standard and four ethnic-specific standards. RESULTS: Despite their lower mean birth weights and higher SGA rates (when based on a single standard), Chinese and South Asian infants had lower perinatal mortality risks throughout gestation. The opposite pattern was observed for First Nations births: higher mean birth weights, lower revealed SGA rates, and higher perinatal mortality risks. When SGA was based on ethnic-specific standards, however, the pattern was concordant with that observed for perinatal mortality. CONCLUSION: The concordance of perinatal mortality and SGA rates when based on ethnic-specific standards, and their discordance when based on a single standard, strongly suggests that the observed ethnic differences in fetal growth are physiologic, rather than pathologic, and make a strong case for ethnic-specific standards.
Source Title: BMC pregnancy and childbirth
URI: https://scholarbank.nus.edu.sg/handle/10635/177982
ISSN: 14712393
DOI: 10.1186/1471-2393-8-1
Rights: Attribution 4.0 International
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