Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women

Background Fetal growth restriction is defined as failure to reach growth potential and considered one of the major complications of pregnancy. These infants are often, although not universally, small for gestational age (SGA). SGA is defined as a weight less than a specified percentile (usually the 10th percentile). Identification of SGA infants is important because these infants are at increased risk of perinatal morbidity and mortality. Screening for SGA is a challenge for all maternity care providers and current methods of clinical assessment fail to detect many infants that are SGA. Large observational studies suggest that customised growth charts may be better able to differentiate between constitutional and pathologic smallness. Customised charts adjust for physiological variables such as maternal weight and height, ethnicity and parity. Objectives To assess the benefits and harms of using population-based growth charts compared with customised growth charts as a screening tool for detection of fetal growth in pregnant women. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011), reviewed published guidelines and searched the reference lists of review articles. Selection criteria Randomised, quasi-randomised or cluster randomised clinical trials comparing customised versus population-based growth charts used as a screening tool for detection of fetal growth in pregnant women. Data collection and analysis Two review authors independently assessed trials for inclusion. Main results No randomised trials met the inclusion criteria.