{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:44:31Z","timestamp":1790664271595,"version":"4.1.0"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T00:00:00Z","timestamp":1499299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2017,8]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To compare the effectiveness of customized vs<\/jats:italic> population\u2010based growth charts for the prediction of adverse pregnancy outcomes.<\/jats:p><\/jats:sec>Methods<\/jats:title>MEDLINE<\/jats:styled-content>, ClinicalTrials.gov<\/jats:ext-link> and The Cochrane Library were searched up to 31 May 2016 to identify interventional and observational studies comparing adverse outcomes among large\u2010 (LGA<\/jats:styled-content>) and small\u2010 (SGA<\/jats:styled-content>) for\u2010gestational\u2010age neonates, when classified according to customized vs<\/jats:italic> population\u2010based growth charts. Perinatal mortality and admission to the neonatal intensive care unit (NICU<\/jats:styled-content>) of both SGA<\/jats:styled-content> and LGA<\/jats:styled-content> neonates, intrauterine fetal demise (IUFD<\/jats:styled-content>) and neonatal mortality of SGA<\/jats:styled-content> neonates, and neonatal shoulder dystocia and hypoglycemia as well as maternal third\u2010 and fourth\u2010degree perineal lacerations in LGA pregnancies were evaluated.<\/jats:p><\/jats:sec>Results<\/jats:title>The electronic search identified 237 records that were examined based on title and abstract, of which 27 full\u2010text articles were examined for eligibility. After excluding seven articles, 20 observational studies were included in a Bayesian meta\u2010analysis. Neonates classified as SGA<\/jats:styled-content> according to customized growth charts had higher risks of IUFD<\/jats:styled-content> (odds ratio (OR<\/jats:styled-content>), 7.8 (95% CI<\/jats:styled-content>, 4.2\u201312.3)), neonatal death (OR<\/jats:styled-content>, 3.5 (95% CI<\/jats:styled-content>, 1.1\u20138.0)), perinatal death (OR<\/jats:styled-content>, 5.8 (95% CI<\/jats:styled-content>, 3.8\u20137.8)) and NICU<\/jats:styled-content> admission (OR<\/jats:styled-content>, 3.6 (95% CI<\/jats:styled-content>, 2.0\u20135.5)) than did non\u2010SGA<\/jats:styled-content> cases. Neonates classified as SGA<\/jats:styled-content> according to population\u2010based growth charts also had increased risk for adverse outcomes, albeit the point estimates of the pooled ORs<\/jats:styled-content> were smaller: IUFD<\/jats:styled-content> (OR<\/jats:styled-content>, 3.3 (95% CI<\/jats:styled-content>, 1.9\u20135.0)), neonatal death (OR<\/jats:styled-content>, 2.9 (95% CI<\/jats:styled-content>, 1.2\u20134.5)), perinatal death (OR<\/jats:styled-content>, 4.0 (95% CI<\/jats:styled-content>, 2.8\u20135.1)) and NICU<\/jats:styled-content> admission (OR<\/jats:styled-content>, 2.4 (95% CI<\/jats:styled-content>, 1.7\u20133.2)). For LGA<\/jats:styled-content> vs<\/jats:italic> non\u2010LGA<\/jats:styled-content>, there were no differences in pooled ORs<\/jats:styled-content> for perinatal death, NICU<\/jats:styled-content> admission, hypoglycemia and maternal third\u2010 and fourth\u2010degree perineal lacerations when classified according to either the customized or the population\u2010based approach. In contrast, both approaches indicated that LGA<\/jats:styled-content> neonates are at increased risk for shoulder dystocia than are non\u2010LGA<\/jats:styled-content> ones (OR<\/jats:styled-content>, 7.4 (95% CI<\/jats:styled-content>, 4.9\u20139.8) using customized charts; OR<\/jats:styled-content>, 8.0 (95% CI<\/jats:styled-content>, 5.3\u201310.1) using population\u2010based charts).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Both customized and population\u2010based growth charts can identify SGA<\/jats:styled-content> neonates at risk for adverse outcomes. Although the point estimates of the pooled ORs<\/jats:styled-content> may differ for some outcomes, the overlapping CIs<\/jats:styled-content> and lack of direct comparisons prevent conclusions from being drawn on the superiority of one method. Future clinical trials should compare directly the two approaches in the management of fetuses of abnormal size. Copyright \u00a9 2016 ISUOG. 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