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Birthweight charts tailored to specific ethnic groups may be better

predictor of adverse outcomes
Date: November 10, 2014

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Source: St. Michael's Hospital

Summary: Immigrant women give birth to about one-third of the babies born in
Ontario. Yet clinicians still measure those babies before and after birth
using the same scales that measure babies whose mothers were born
in Canada, often of Western European ancestry.

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mmigrant women give birth to about one-third of the babies born in

Ontario. Yet clinicians still measure those babies before and after birth
using the same scales that measure babies whose mothers were born in
Canada, often of Western European ancestry.
As a result, many babies born to immigrant mothers,
especially those from South and East Asia, may be
incorrectly labelled small for their gestational age or
large for their gestational age, according to research
published today in the Canadian Medical Association
Journal.

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Those designations can trigger medical interventions,

such as heightened monitoring and follow-up care for

Birth weight

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small babies, which may not be necessary, said Dr.

Breastfeeding
Marcelo Urquia, an epidemiologist at the Centre for
Research on Inner City Health of St. Michael's Hospital
and an adjunct scientist at the Institute for Clinical
Evaluative Sciences. Or, they may miss large babies associated with complicated
deliveries.
Dr. Urquia and colleagues have developed a series of birthweight curves for specific
regions of the world--graphs used to plot how one newborn's weight compares to
others. A baby whose birthweight is in the lowest tenth percentile of the curve is
deemed to be "small for gestational age." One whose birthweight is in the highest
tenth percentile is deemed to be "large for gestational age."
Dr. Urquia looked at 1,089,647 single births in Ontario between 2002 and 2012. About
one-third of those babies (328,387) were born to immigrant mothers, of whom more
than half (53.6 per cent) were of East and South Asian origin.
About 10 per cent (33,780) of infants born to immigrant mothers were classified as
small for gestational age on both the Canadian and regional scales. These babies were
more likely to die or suffer adverse events than heavier infants, Dr. Urquia said.
About 6 per cent of additional infants born to immigrant mothers were classified as
small for gestational age on the Canadian curve but not on the birthweight curve for the
mother's country of origin.
Compared to newborns of Canadian-born mothers, newborns of immigrant mothers
classified as small for gestational age on the Canadian curve had lower odds of
adverse events such as a lengthy hospital stay or death. But babies classified as
small on the world-region specific curves were more likely to die or suffer adverse
events.
Approximately 5.4 per cent of babies to immigrant mothers were deemed large for
gestational age when using both curves and about 4.3 per cent were classified as large
when using only the world-region specific curves. These deliveries of babies missed by
the Canadian curve also exhibited complications associated with large babies, such as
perineal tears in the mother, shoulder dystocia (when the baby's shoulder gets stuck
behind the mother's public bone, preventing easy delivery) and postpartum
hemorrhage.

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"World region-specific curves seem more appropriate than a single Canadian curve for
assessing the impact of small for gestational age and large for gestational age on

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assessing the impact of small for gestational age and large for gestational age on
adverse neonatal and obstetrical outcomes among some immigrant groups,
particularly those whose birth weight distributions differ markedly from that of the local
population, such as East and South Asian immigrants," Dr. Urquia wrote.
"Estimating the number of newborns conceivably spared unnecessary prolonged stay
in hospital, special care, or referral for specialized pediatric or nutritional interventions
and the cost savings therein, is a worthwhile step in evaluating the impact of adopting
world region-specific curves among certain immigrant populations."
Story Source:
The above story is based on materials provided by St. Michael's Hospital. The
original article was written by Leslie Shepherd. Note: Materials may be edited for
content and length.
Journal Reference:
1. Marcelo L. Urquia, Howard Berger, Joel G. Ray, for the Canadian Curves
Consortium. Risk of adverse outcomes among infants of immigrant women
according to birth-weight curves tailored to maternal world region of origin.
CMAJ, November 2014 DOI: 10.1503/cmaj.140748

APA

Chicago

St. Michael's Hospital. "Birthweight charts tailored to specific ethnic groups may
be better predictor of adverse outcomes." ScienceDaily. ScienceDaily, 10
November 2014. <www.sciencedaily.com/releases/2014/11/141110124140.htm>.

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