Customized versus population approach for evaluation of fetal overgrowth

Magedm Costantine, Lisa Mele, Markb Landon, Catheriney Spong, Susanm Ramin, Brian Casey, Ronaldj Wapner, Michaelw Varner, Dwightj Rouse, Johnm Thorp, Anthony Sciscione, Patrick Catalano, Steven Caritis, Yoram Sorokin, Alanm Peaceman, Jorgee Tolosa, Garlandd Anderson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective To compare the ability of customized versus normalized population fetal growth norms in identifying neonates at risk for adverse perinatal outcomes (APOs) associated with fetal overgrowth and gestational diabetes (GDM). Study Design Secondary analysis of a multicenter treatment trial of mild GDM. The primary outcome was a composite of neonatal outcomes associated with fetal overgrowth and GDM. Birth weight percentiles were calculated using ethnicity- and gender-specific population and customized norms (Gardosi). Results Two hundred three (9.8%) and 288 (13.8%) neonates were large for gestational age by population (LGApop) and customized (LGAcust) norms, respectively. Both LGApop and LGAcust were associated with the primary outcome and neonatal hyperinsulinemia, but neither was associated with hypoglycemia or hyperbilirubinemia. The ability of customized and population birth weight percentiles for predicting APOs were poor (area under the receiver operating characteristic curve < 0.6 for six of eight APOs). Conclusion Neither customized nor normalized population norms better identify neonates at risk of APOs related to fetal overgrowth and GDM.

Original languageEnglish (US)
Pages (from-to)565-572
Number of pages8
JournalAmerican Journal of Perinatology
Issue number7
StatePublished - 2013
Externally publishedYes


  • adverse neonatal outcomes
  • customized growth
  • gestational diabetes
  • large for gestational age

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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