Fetal Growth Assesment (SGA/AGA/LGA)

[Marina A]

Hi all,
I am curious what tools your nurseries use to identify SGA/LGA?
We used the Lubchenco curve from the 60s (the tool is on medcalc.com) but there are more recent standards vigtigt link. Here are some of the latest publications
https://www.elsevier.com/about/press-releases/research-and-journals/which-fetal-size-standard-should-be-used-for-diagnosing-a-small-or-large-for-gestational-age-fetus
https://www.ajog.org/article/S0002-9378(17)32716-3/fulltext
https://www.aap.org/en-us/Documents/GrowthCurves.pdf

[Suzanne Ritter]

Hi Marina,
We use the Fenton growth curve (2003) that is available in CPN and with plots greater than 90% LGA and plots less than 10% SGA all else is AGA. I would be interested to know what others are using as well. I am going to read the articles you posted. Thanks for posting them.
Suzanne

[Marina A]

Hi Suzanne, thanks for the reply.
Are you using the 2003 version? Not 2013? The 2013 chart can be build in GE CPN but it needs to be 6.96 SP2 at least. There is an infobyte on this. Unfortunately, Fenton chart cannot be used for term babies. GE has a licensing agreement with the author that it would be used as intended, i.e. for preterm babies only.
I found Intergrowth 21 initiative and one of their calculators

INTERGROWTH-21st

We are having Pediatric Committee soon, so hopefully they will look into this…

[Suzanne Ritter]

Hi Marina and CPNUG,
I am a nurse working in IT as the CPN System Manager. My experience is in adult ICU and Case Management so I wasn’t even aware that the Fenton was purely for pre-term infants. Thank you so much for you reply. We have updated our Fenton to the 2013 versions and have added the WHO Growth Charts Boy/Girl to the Nursery side (from the GE Infobyte). However; the Nursery nurses are stating that the WHO Growth Charts that I just built in CPN (created from GE Infobyte) are not for Newborns and should be used for Pediatric patients only. The infobyte itself states it can be used for Newborns unless I am reading this wrong. Would love some comments regarding this. Can these growth charts be accurately used for Term Newborns? Does anyone else use them? Thanks for your time!!

Info that is on the GE Infobyte –

WORLD HEALTH Org (WHO) growth charts
Purpose:
This infobyte outlines changes with the growth chart configuration that took effect as part of the Centricity Perinatal CPN 6.96 SP2 release. The configuration adds newborn growth charts to the newborn nursery documentation utilizing data sets from the World Health Organization (WHO) Child Growth Standards. The reference curves (data sets) for the WHO Child Growth Standards World Health Organization 2006 were reproduced with permission: WHO child growth standards: length/height for age, weight for age, weight for length, weight for height and body mass index for age: methods and development World Health Organization 2006. Sites who manage their own configuration may use these instructions to modify their configuration.

[Marina A]

Hi Suzanne, glad you were able to build new charts! We are still on an older version and can’t update our Fenton’s. Our nurses looked at WHO charts and expressed the same concern. It is very difficult to use them for newborns. Our doctors are still reviewing the tools. I personally advocate for Intergrowth-21. And the calculation tool is really great. I am putting in a product feature request with GE. Will update on the progress.

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