INTERGROWTH-21st v. local South African growth standards (Theron-Thompson) for identification of small-for-gestational-age fetuses in stillbirths : a closer look at variation across pregnancy

• Published in: South African medical journal Vol. 109; no. 7; pp. 519 - 525
• Main Authors: Lavin, T., Theron, G., Pattinson, R.C., Preen, D., Nedkoff, L.
• Format: Journal Article
• Language: English
• Published: South Africa Health and Medical Publishing Group (HMPG) 01-07-2019; Health & Medical Publishing Group
• Subjects: Comparative analysis; Female; Fetal Development - physiology; Fetal Growth Retardation; Gestational Age; Growth; Growth Charts; HIV Infections - epidemiology; Humans; Infant, Small for Gestational Age; Parity; Pregnancy; Pregnant women; Premature Birth - epidemiology; Prenatal Care - statistics & numerical data; Prevalence; South Africa - epidemiology; Stillbirth; South Africa; Australia
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2019.v109i7.13485

Background. Global growth standards for fetuses were recently developed (INTERGROWTH-21st). It has been advocated that professional bodies should adopt these global standards.Objectives. To compare the ability of INTERGROWTH-21st with local standards (Theron-Thompson) to identify small-for-gestational-age (SGA) fetuses in stillbirths in the South African (SA) setting.Methods. Stillbirths across SA were investigated (>500 g, 28 - 40 weeks) between October 2013 and December 2016 (N=14 776). The study applied the INTERGROWTH-21st standards to classify stillbirths as Results. The prevalence of SGA was estimated at 32.2% and 31.1% by INTERGROWTH-21st and Theron-Thompson, respectively. INTERGROWTH-21st captured 13.8% more stillbirths as SGA in the earlier gestations (28 - 30 weeks, pConclusions. Our findings demonstrated differences in the proportion of stillbirths considered SGA at each gestational age between the INTERGROWTH-21st and the local SA standard, which have not been considered previously by other studies.