Does one size fit all? The case for ethnic-specific standards of fetal growth
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....
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ftdoajarticles:oai:doaj.org/article:b8fb634d5f584fc1b9647c599c4019b9 2023-05-15T16:15:59+02:00 Does one size fit all? The case for ethnic-specific standards of fetal growth Wilkins Russell Platt Robert Luo Zhong-Cheng Joseph KS Kierans William J Kramer Michael S 2008-01-01T00:00:00Z https://doi.org/10.1186/1471-2393-8-1 https://doaj.org/article/b8fb634d5f584fc1b9647c599c4019b9 EN eng BMC http://www.biomedcentral.com/1471-2393/8/1 https://doaj.org/toc/1471-2393 doi:10.1186/1471-2393-8-1 1471-2393 https://doaj.org/article/b8fb634d5f584fc1b9647c599c4019b9 BMC Pregnancy and Childbirth, Vol 8, Iss 1, p 1 (2008) Gynecology and obstetrics RG1-991 article 2008 ftdoajarticles https://doi.org/10.1186/1471-2393-8-1 2022-12-30T23:49:03Z 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" (< 10 th 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. Article in Journal/Newspaper First Nations Directory of Open Access Journals: DOAJ Articles Indian BMC Pregnancy and Childbirth 8 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Gynecology and obstetrics RG1-991 |
spellingShingle |
Gynecology and obstetrics RG1-991 Wilkins Russell Platt Robert Luo Zhong-Cheng Joseph KS Kierans William J Kramer Michael S Does one size fit all? The case for ethnic-specific standards of fetal growth |
topic_facet |
Gynecology and obstetrics RG1-991 |
description |
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" (< 10 th 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. |
format |
Article in Journal/Newspaper |
author |
Wilkins Russell Platt Robert Luo Zhong-Cheng Joseph KS Kierans William J Kramer Michael S |
author_facet |
Wilkins Russell Platt Robert Luo Zhong-Cheng Joseph KS Kierans William J Kramer Michael S |
author_sort |
Wilkins Russell |
title |
Does one size fit all? The case for ethnic-specific standards of fetal growth |
title_short |
Does one size fit all? The case for ethnic-specific standards of fetal growth |
title_full |
Does one size fit all? The case for ethnic-specific standards of fetal growth |
title_fullStr |
Does one size fit all? The case for ethnic-specific standards of fetal growth |
title_full_unstemmed |
Does one size fit all? The case for ethnic-specific standards of fetal growth |
title_sort |
does one size fit all? the case for ethnic-specific standards of fetal growth |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1471-2393-8-1 https://doaj.org/article/b8fb634d5f584fc1b9647c599c4019b9 |
geographic |
Indian |
geographic_facet |
Indian |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
BMC Pregnancy and Childbirth, Vol 8, Iss 1, p 1 (2008) |
op_relation |
http://www.biomedcentral.com/1471-2393/8/1 https://doaj.org/toc/1471-2393 doi:10.1186/1471-2393-8-1 1471-2393 https://doaj.org/article/b8fb634d5f584fc1b9647c599c4019b9 |
op_doi |
https://doi.org/10.1186/1471-2393-8-1 |
container_title |
BMC Pregnancy and Childbirth |
container_volume |
8 |
container_issue |
1 |
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1766001850999373824 |