Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study
Objective To assess the impact of increasing obstetric intervention on birthweight centiles. Design Retrospective cohort study of births in five 2‐year epochs: 1983–84, 1993–94, 2003–2004, 2013–2014 and 2016–2017. Population 665 205 singleton births at ≥32 weeks' gestation. Setting All maternit...
Gespeichert in:
| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2020-08, Vol.127 (9), p.1074-1080 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1080 |
|---|---|
| container_issue | 9 |
| container_start_page | 1074 |
| container_title | BJOG : an international journal of obstetrics and gynaecology |
| container_volume | 127 |
| creator | Selvaratnam, RJ Davey, M‐A Mol, BW Wallace, EM |
| description | Objective
To assess the impact of increasing obstetric intervention on birthweight centiles.
Design
Retrospective cohort study of births in five 2‐year epochs: 1983–84, 1993–94, 2003–2004, 2013–2014 and 2016–2017.
Population
665 205 singleton births at ≥32 weeks' gestation.
Setting
All maternity services in Victoria, Australia.
Methods
For each epoch, we calculated the birthweight cutoffs defining each birthweight centile at 34, 37 and 40 weeks' gestation. We calculated rates of iatrogenic delivery over time. We then calculated the number of babies whose birthweight would have classified them as ≥3rd centile based on 1983–84 centile definitions but as |
| doi_str_mv | 10.1111/1471-0528.16215 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2377993383</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2377993383</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3715-e8f94b78f6be66abe36ade8ee3d5c6da73433815b557c6da94bf141d1a1d068c3</originalsourceid><addsrcrecordid>eNqFkTFv2zAQhYmiQeMmnbsVBLpkkc0TRYnu1gRpmyBAlmQmKOpk0ZBFl6RieMh_D2WnGbqEy5HH7z0c-Qj5CmwOaS2gqCBjIpdzKHMQH8jsrfPxsGcZ47k8JZ9DWDOWIMY_kVOeg2QcYEaebwbjUQc7rKirQ8ToraF2iOifcIjWDbR1nrYYdU9X3u1iRz2GiTpc2kBDZ9s46WvrY7dDu-oiNZO4x_CD6sRH78IWk-IJqXGd85GGODb7c3LS6j7gl9d6Rh5_XT9c_cnu7n_fXP28ywyvQGQo22VRV7ItayxLXSMvdYMSkTfClI2ueMG5BFELUU3nBLdQQAMaGlZKw8_IxdF3693fMY2vNjYY7Hs9oBuDynlVLZfJgyf0-3_o2o1-SNOpvMghr_hSyEQtjpRJLwseW7X1dqP9XgFTUzJqykFNOahDMknx7dV3rDfYvPH_okiAOAK79G_79_zU5e390fgFTpua6Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2421273958</pqid></control><display><type>article</type><title>Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Selvaratnam, RJ ; Davey, M‐A ; Mol, BW ; Wallace, EM</creator><creatorcontrib>Selvaratnam, RJ ; Davey, M‐A ; Mol, BW ; Wallace, EM</creatorcontrib><description>Objective
To assess the impact of increasing obstetric intervention on birthweight centiles.
Design
Retrospective cohort study of births in five 2‐year epochs: 1983–84, 1993–94, 2003–2004, 2013–2014 and 2016–2017.
Population
665 205 singleton births at ≥32 weeks' gestation.
Setting
All maternity services in Victoria, Australia.
Methods
For each epoch, we calculated the birthweight cutoffs defining each birthweight centile at 34, 37 and 40 weeks' gestation. We calculated rates of iatrogenic delivery over time. We then calculated the number of babies whose birthweight would have classified them as ≥3rd centile based on 1983–84 centile definitions but as <3rd centile based on 2016–2017 centile definitions.
Main outcome measures
Birthweight centile, and gestation at delivery.
Results
From 1983–84 to 2016–2017, the rate of iatrogenic delivery for singleton pregnancies increased at all term gestations: 1.6–6.4% at 37 weeks', 4.5–18.3% at 38 weeks', 7.6–23.9% at 39 weeks' and 18.4–25.1% at 40 weeks' (all P < 0.001). Over the same period, the birthweight cutoffs defining the 3rd, 5th and 10th centiles increased significantly at term, but not preterm, gestations. This led to increasing numbers of term births being classified as small for gestational age (SGA). Of the 2748 babies born in 2016–2017 at 37–39 weeks' gestation with a birthweight <3rd centile in that period, 1478 (53.8%) would have been classified as ≥3rd centile based on 1983–84 centile definitions.
Conclusion
Increasing intervention is shifting the birthweight cutoffs that define birthweight centiles and thereby redefining what constitutes SGA. This undermines the use of population‐derived birthweight centiles to audit clinical care.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.16215</identifier><identifier>PMID: 32180311</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Birth weight ; Births ; Birthweight ; Cohort analysis ; fetal growth restriction ; Fetuses ; Gestational age ; Health risk assessment ; iatrogenic ; induction of labour ; intervention ; morbidity ; Obesity ; Obstetrics ; Premature birth ; Small for gestational age ; stillbirth ; trends</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2020-08, Vol.127 (9), p.1074-1080</ispartof><rights>2020 Royal College of Obstetricians and Gynaecologists</rights><rights>2020 Royal College of Obstetricians and Gynaecologists.</rights><rights>Copyright © 2020 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3715-e8f94b78f6be66abe36ade8ee3d5c6da73433815b557c6da94bf141d1a1d068c3</citedby><cites>FETCH-LOGICAL-c3715-e8f94b78f6be66abe36ade8ee3d5c6da73433815b557c6da94bf141d1a1d068c3</cites><orcidid>0000-0001-8337-550X ; 0000-0003-4240-5594 ; 0000-0002-4506-5233 ; 0000-0002-8574-0109</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.16215$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.16215$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32180311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selvaratnam, RJ</creatorcontrib><creatorcontrib>Davey, M‐A</creatorcontrib><creatorcontrib>Mol, BW</creatorcontrib><creatorcontrib>Wallace, EM</creatorcontrib><title>Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective
To assess the impact of increasing obstetric intervention on birthweight centiles.
Design
Retrospective cohort study of births in five 2‐year epochs: 1983–84, 1993–94, 2003–2004, 2013–2014 and 2016–2017.
Population
665 205 singleton births at ≥32 weeks' gestation.
Setting
All maternity services in Victoria, Australia.
Methods
For each epoch, we calculated the birthweight cutoffs defining each birthweight centile at 34, 37 and 40 weeks' gestation. We calculated rates of iatrogenic delivery over time. We then calculated the number of babies whose birthweight would have classified them as ≥3rd centile based on 1983–84 centile definitions but as <3rd centile based on 2016–2017 centile definitions.
Main outcome measures
Birthweight centile, and gestation at delivery.
Results
From 1983–84 to 2016–2017, the rate of iatrogenic delivery for singleton pregnancies increased at all term gestations: 1.6–6.4% at 37 weeks', 4.5–18.3% at 38 weeks', 7.6–23.9% at 39 weeks' and 18.4–25.1% at 40 weeks' (all P < 0.001). Over the same period, the birthweight cutoffs defining the 3rd, 5th and 10th centiles increased significantly at term, but not preterm, gestations. This led to increasing numbers of term births being classified as small for gestational age (SGA). Of the 2748 babies born in 2016–2017 at 37–39 weeks' gestation with a birthweight <3rd centile in that period, 1478 (53.8%) would have been classified as ≥3rd centile based on 1983–84 centile definitions.
Conclusion
Increasing intervention is shifting the birthweight cutoffs that define birthweight centiles and thereby redefining what constitutes SGA. This undermines the use of population‐derived birthweight centiles to audit clinical care.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.</description><subject>Birth weight</subject><subject>Births</subject><subject>Birthweight</subject><subject>Cohort analysis</subject><subject>fetal growth restriction</subject><subject>Fetuses</subject><subject>Gestational age</subject><subject>Health risk assessment</subject><subject>iatrogenic</subject><subject>induction of labour</subject><subject>intervention</subject><subject>morbidity</subject><subject>Obesity</subject><subject>Obstetrics</subject><subject>Premature birth</subject><subject>Small for gestational age</subject><subject>stillbirth</subject><subject>trends</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkTFv2zAQhYmiQeMmnbsVBLpkkc0TRYnu1gRpmyBAlmQmKOpk0ZBFl6RieMh_D2WnGbqEy5HH7z0c-Qj5CmwOaS2gqCBjIpdzKHMQH8jsrfPxsGcZ47k8JZ9DWDOWIMY_kVOeg2QcYEaebwbjUQc7rKirQ8ToraF2iOifcIjWDbR1nrYYdU9X3u1iRz2GiTpc2kBDZ9s46WvrY7dDu-oiNZO4x_CD6sRH78IWk-IJqXGd85GGODb7c3LS6j7gl9d6Rh5_XT9c_cnu7n_fXP28ywyvQGQo22VRV7ItayxLXSMvdYMSkTfClI2ueMG5BFELUU3nBLdQQAMaGlZKw8_IxdF3693fMY2vNjYY7Hs9oBuDynlVLZfJgyf0-3_o2o1-SNOpvMghr_hSyEQtjpRJLwseW7X1dqP9XgFTUzJqykFNOahDMknx7dV3rDfYvPH_okiAOAK79G_79_zU5e390fgFTpua6Q</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Selvaratnam, RJ</creator><creator>Davey, M‐A</creator><creator>Mol, BW</creator><creator>Wallace, EM</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8337-550X</orcidid><orcidid>https://orcid.org/0000-0003-4240-5594</orcidid><orcidid>https://orcid.org/0000-0002-4506-5233</orcidid><orcidid>https://orcid.org/0000-0002-8574-0109</orcidid></search><sort><creationdate>202008</creationdate><title>Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study</title><author>Selvaratnam, RJ ; Davey, M‐A ; Mol, BW ; Wallace, EM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3715-e8f94b78f6be66abe36ade8ee3d5c6da73433815b557c6da94bf141d1a1d068c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Birth weight</topic><topic>Births</topic><topic>Birthweight</topic><topic>Cohort analysis</topic><topic>fetal growth restriction</topic><topic>Fetuses</topic><topic>Gestational age</topic><topic>Health risk assessment</topic><topic>iatrogenic</topic><topic>induction of labour</topic><topic>intervention</topic><topic>morbidity</topic><topic>Obesity</topic><topic>Obstetrics</topic><topic>Premature birth</topic><topic>Small for gestational age</topic><topic>stillbirth</topic><topic>trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Selvaratnam, RJ</creatorcontrib><creatorcontrib>Davey, M‐A</creatorcontrib><creatorcontrib>Mol, BW</creatorcontrib><creatorcontrib>Wallace, EM</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Selvaratnam, RJ</au><au>Davey, M‐A</au><au>Mol, BW</au><au>Wallace, EM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2020-08</date><risdate>2020</risdate><volume>127</volume><issue>9</issue><spage>1074</spage><epage>1080</epage><pages>1074-1080</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><abstract>Objective
To assess the impact of increasing obstetric intervention on birthweight centiles.
Design
Retrospective cohort study of births in five 2‐year epochs: 1983–84, 1993–94, 2003–2004, 2013–2014 and 2016–2017.
Population
665 205 singleton births at ≥32 weeks' gestation.
Setting
All maternity services in Victoria, Australia.
Methods
For each epoch, we calculated the birthweight cutoffs defining each birthweight centile at 34, 37 and 40 weeks' gestation. We calculated rates of iatrogenic delivery over time. We then calculated the number of babies whose birthweight would have classified them as ≥3rd centile based on 1983–84 centile definitions but as <3rd centile based on 2016–2017 centile definitions.
Main outcome measures
Birthweight centile, and gestation at delivery.
Results
From 1983–84 to 2016–2017, the rate of iatrogenic delivery for singleton pregnancies increased at all term gestations: 1.6–6.4% at 37 weeks', 4.5–18.3% at 38 weeks', 7.6–23.9% at 39 weeks' and 18.4–25.1% at 40 weeks' (all P < 0.001). Over the same period, the birthweight cutoffs defining the 3rd, 5th and 10th centiles increased significantly at term, but not preterm, gestations. This led to increasing numbers of term births being classified as small for gestational age (SGA). Of the 2748 babies born in 2016–2017 at 37–39 weeks' gestation with a birthweight <3rd centile in that period, 1478 (53.8%) would have been classified as ≥3rd centile based on 1983–84 centile definitions.
Conclusion
Increasing intervention is shifting the birthweight cutoffs that define birthweight centiles and thereby redefining what constitutes SGA. This undermines the use of population‐derived birthweight centiles to audit clinical care.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.
Tweetable
Increasing obstetric intervention is shifting birthweight centiles and therefore definitions of normality.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32180311</pmid><doi>10.1111/1471-0528.16215</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8337-550X</orcidid><orcidid>https://orcid.org/0000-0003-4240-5594</orcidid><orcidid>https://orcid.org/0000-0002-4506-5233</orcidid><orcidid>https://orcid.org/0000-0002-8574-0109</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2020-08, Vol.127 (9), p.1074-1080 |
| issn | 1470-0328 1471-0528 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2377993383 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Birth weight Births Birthweight Cohort analysis fetal growth restriction Fetuses Gestational age Health risk assessment iatrogenic induction of labour intervention morbidity Obesity Obstetrics Premature birth Small for gestational age stillbirth trends |
| title | Increasing obstetric intervention for fetal growth restriction is shifting birthweight centiles: a retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T15%3A53%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Increasing%20obstetric%20intervention%20for%20fetal%20growth%20restriction%20is%20shifting%20birthweight%20centiles:%20a%20retrospective%20cohort%20study&rft.jtitle=BJOG%20:%20an%20international%20journal%20of%20obstetrics%20and%20gynaecology&rft.au=Selvaratnam,%20RJ&rft.date=2020-08&rft.volume=127&rft.issue=9&rft.spage=1074&rft.epage=1080&rft.pages=1074-1080&rft.issn=1470-0328&rft.eissn=1471-0528&rft_id=info:doi/10.1111/1471-0528.16215&rft_dat=%3Cproquest_cross%3E2377993383%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2421273958&rft_id=info:pmid/32180311&rfr_iscdi=true |