FIGO position paper on reference charts for fetal growth and size at birth: Which one to use?

Publication of the Intergrowth‐21st and WHO growth charts raises the question of which growth data prenatal providers should use in clinical practice. Is it better to use a universal chart applied globally, or metrics based on local or regional growth patterns? And what about customized charts versus local charts? FIGO has reviewed the different growth charts and studies assessing their reproducibility and predictive values for small‐ and large‐for‐gestational age newborns and, where available, adverse fetal outcomes. It concludes that local or regional charts are likely to be best for identifying the 10th percentile of newborns at highest risk. However, international standards for growth may also be used when coupled with locally appropriate thresholds for risk interpretation. Local fetal growth charts better identify fetuses at highest risk. Global charts may be used, but with a locally appropriate threshold for risk interpretation.