{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:10:10Z","timestamp":1785499810441,"version":"3.56.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The assessment of birthweight for gestational age and the identification of small\u2010 and large\u2010for\u2010gestational age (SGA and LGA) infants remain contentious, despite the recent creation of the Intergrowth 21st Project and World Health Organisation (WHO) birthweight\u2010for\u2010gestational age standards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We carried out a study to identify birthweight\u2010for\u2010gestational age cut\u2010offs, and corresponding population\u2010based, Intergrowth 21st and WHO centiles associated with higher risks of adverse neonatal outcomes, and to evaluate their ability to predict serious neonatal morbidity and neonatal mortality (SNMM) at term gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study population was based on non\u2010anomalous, singleton live births between 37 and 41\u2009weeks' gestation in the United States from 2003 to 2017. SNMM included 5\u2010min Apgar score &lt;4, neonatal seizures, need for assisted ventilation, and neonatal death. Birthweight\u2010specific SNMM was modelled by gestational week using penalised B\u2010splines. The birthweights at which SNMM odds were minimised (and higher by 10%, 50% and 100%) were estimated,\u00a0and the corresponding population, Intergrowth 21st, and WHO centiles were identified. The clinical performance and population impact of these cut\u2010offs for predicting SNMM were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 40,179,663 live births and 991,486 SNMM cases. Among female singletons at 39\u2009weeks' gestation, SNMM odds was lowest at 3203\u2009g birthweight, and 10% higher at 2835\u2009g and 3685\u2009g (population centiles 11th and 82nd, Intergrowth centiles 17th and 88th and WHO centiles 15th and 85th). Birthweight cut\u2010offs were poor predictors of SNMM, for example, the cut\u2010offs associated with 10% and 50% higher odds of SNMM among female singletons at 39\u2009weeks' gestation resulted in a sensitivity, specificity, and population attributable fraction of 12.5%, 89.4%, and 2.1%, and 2.9%, 98.4% and 1.3%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reference\u2010 and standard\u2010based birthweight\u2010for\u2010gestational age indices and centiles perform poorly for predicting adverse neonatal outcomes in individual infants, and their associated population impact is also small.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12994","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T07:14:10Z","timestamp":1687245250000},"page":"1-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The clinical performance and population health impact of birthweight\u2010for\u2010gestational age indices at term gestation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1119-8772","authenticated-orcid":false,"given":"Sid","family":"John","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2317-5607","authenticated-orcid":false,"given":"K. 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