Department of Growth and Development, Capital Institute of Pediatrics, No. 2, Ya Bao Road, Chaoyang District, Beijing, China.
World J Pediatr. 2023 Jan;19(1):96-105. doi: 10.1007/s12519-022-00631-4. Epub 2022 Oct 28.
INTERGROWTH-21st Newborn Cross-Sectional Study (NCSS) charts were established and recommended for global application. However, whether one international reference is appropriate for all populations is still unclear. We aim to compare the updated Chinese birth size charts by gestational age with INTERGROWTH-21st NCSS charts.
A cross-sectional survey was carried out, and the birth weight, length and head circumference of 24,375 infants born after uncomplicated pregnancies at gestational age ranging from 24 to 42 weeks were measured in 13 cities in China from 2015 to 2018. Growth charts were constructed. The measurements of all these infants were evaluated by the methods of calculating their Z scores using the INTERGROWTH-21st standards. The prevalence of small for gestational age (SGA) and large for gestational age (LGA) based on birth weight was analyzed using Chinese charts and INTERGROWTH-21st charts.
The mean Z scores were 0.10 for birth weight, 0.35 for length and - 0.02 for head circumference. Compared to the INTERGROWTH-21st charts, the Chinese birth weight percentile curves were higher except for the 90th percentile at 29-37 weeks gestational age, and the length percentile curves were higher after 33 weeks gestational age, while the 10th percentile of the head circumference was lower and the other percentiles were similar. The prevalence of SGA was 10.1% [95% confidence interval (CI) = 9.7%-10.5%] using the Chinese birth weight chart and 6.5% (95% CI = 6.2%-6.8%) using the INTERGROWTH-21st birth weight chart. The prevalence of LGA was 9.9% (95% CI = 9.5%-10.2%) and 8.2% (95% CI = 7.9%-8.6%) using the Chinese and INTERGROWTH-21st birth weight charts, respectively.
Chinese birth size charts based on infants born after uncomplicated pregnancies were different from the INTERGROWTH-21st charts. Differences in the classification of newborns by the two charts should receive attention, and whether the application of INTERGROWTH-21st in Chinese newborns will lead to misclassification needs to be validated in future clinical practice.
INTERGROWTH-21 新生儿横断面研究（NCSS）图表已经建立并推荐在全球范围内使用。然而，一个国际参考标准是否适用于所有人群尚不清楚。我们旨在比较基于中国不同胎龄的最新出生大小图表与 INTERGROWTH-21 新生儿 NCSS 图表。
这是一项横断面研究，2015 年至 2018 年期间，在中国 13 个城市，对 24 至 42 周妊娠、无并发症的 24375 例婴儿的出生体重、身长和头围进行了测量。绘制生长图表。使用 INTERGROWTH-21 标准计算 Z 分数的方法对所有这些婴儿的测量值进行评估。根据中国图表和 INTERGROWTH-21 图表，分析基于出生体重的小于胎龄儿（SGA）和大于胎龄儿（LGA）的发生率。
出生体重的平均 Z 分数为 0.10，身长为 0.35，头围为-0.02。与 INTERGROWTH-21 图表相比，中国出生体重百分位曲线除 29-37 周妊娠的第 90 百分位外均较高，身长百分位曲线在 33 周妊娠后较高，而头围的第 10 百分位较低，其他百分位相似。使用中国出生体重图表，SGA 的发生率为 10.1%（95%置信区间[CI]：9.7%-10.5%），使用 INTERGROWTH-21 出生体重图表，SGA 的发生率为 6.5%（95%CI：6.2%-6.8%）。使用中国和 INTERGROWTH-21 出生体重图表，LGA 的发生率分别为 9.9%（95%CI：9.5%-10.2%）和 8.2%（95%CI：7.9%-8.6%）。
基于无并发症妊娠婴儿的中国出生大小图表与 INTERGROWTH-21 图表不同。两种图表对新生儿的分类差异应引起重视，在未来的临床实践中，需要验证在中国人新生儿中应用 INTERGROWTH-21 是否会导致错误分类。
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