B604 - The association of birth weight with physical and cognitive development of schoolchildren population based birth weight standards versus customised birth weight standards

B number: 
B604
Principal applicant name: 
Dr H Wildschut (Erasmus University Medical Center, Rottterdam, the Netherlands, Europe)
Co-applicants: 
Ms Maarjot Danen (Not used 0, Not used 0), Mr Jesper A van Deenan (Not used 0, Not used 0)
Title of project: 
The association of birth weight with physical and cognitive development of schoolchildren: population based birth weight standards versus customised birth weight standards.
Proposal summary: 

Fetal growth is an important indicator of fetal well-being. The timely detection of pathologically impaired fetal growth is a prerequisite for the quality of antenal care, because of its apparent links to perinatal morbidity and mortality1, as well as adverse effects in childhood and later life2.

The prevalence of impaired fetal growth depends on the definition used. Population-based birth weight standards define 'small for gestational age' as the lowest tenth or fifth percentile, or as two standard deviations below the main birth weight for gestational age. This definition, however, includes 'natural' smallness. Therefore, it is essential to adjust for this normal variation in order to identify those infants who are pathologically small. Maternal weight, height, ethnic origin, parity and the infant's gender have all been found to be significantly associated with physiological variation in birth weight3. Professor J Gardosi developed the so-called customised growth charts, which are based on a new definition of fetal growth, thereby focussing on fetal growth potential, which takes in account the aforementioned variables (www.gestation.net).

Customised birth weight percentiles allow distinction between small, healthy newborns and those who are pathologically small3. Individually adjusted birth weight percentiles are more clearly associated with Apgar scores, perinatal outcome and neonatal morphometry indices than the unadjusted birth weight percentiles4. In this context, however, the association with long-term morbidity, such as cognitive and physical development, has never been examined.

ALSPAC is a longitudinal population-based cohort study, which includes all variables needed to analyse the long-term effects of intrauterine growth restriction on physical and cognitive health of schoolchildren.

Date proposal received: 
Monday, 28 January, 2008
Keywords: 
Primary keyword: