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Differences between European birthweight standards: Impact on classification of 'small for gestational age'

Lookup NU author(s): Dr Jane Hutton, Dr Svetlana Glinianaia, Emeritus Professor Stephen Jarvis


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We describe a quantitative and comparative review of a selection of European birthweight standards for gestational age for singletons, to enable appropriate choices to be made for clinical and research use. Differences between median values at term across standards in 10 regions and misclassification of 'small for gestational age' (SGA), were studied. Sex and parity differences, exclusion criteria, and methods of construction were considered. There was wide variation between countries in exclusion criteria, methods of calculating standards, and median birthweight at term. The lightest standards (e.g. France's medians are 255g lower than Norway's medians) were associated with fewer exclusion criteria. Up to 20% of the population used in the construction of the Scottish standard would be classified as SGA using the Norwegian standard. Substantial misclassification of SGA is possible. Assumptions about variation used in the construction of some standards were not justified. It is not possible to conclude that there are real differences in birthweight standards between European countries. Country-based standards control for some population features but add misclassification due to the differing ways in which standards are derived. Standards should be chosen to reflect clinical or research need. If standards stratified by sex or parity are not available, adjustments should be made. In multinational studies, comparisons should be made between results using both a common standard and country-based standards. © 2006 Mac Keith Press.

Publication metadata

Author(s): Hemming K, Hutton JL, Glinianaia SV, Jarvis SN, Platt MJ

Publication type: Article

Publication status: Published

Journal: Developmental Medicine and Child Neurology

Year: 2006

Volume: 48

Issue: 11

Pages: 906-912

ISSN (print): 0012-1622

ISSN (electronic): 1469-8749

Publisher: Mac Keith Press


DOI: 10.1017/S0012162206001988


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Funder referenceFunder name
G0400642Medical Research Council