| Kramer [8] | Niklasson [11] | Beeby [12] | CDC [13] |
---|---|---|---|---|
Data used | Birthweight ≤ 40 weeks | Head and length measures ≤ 40 weeks | Head and length measures ≤ 40 weeks | Weight, head and length measures after term |
Sample size (n) | 676,605 | 376,000 | Head circumference: 29090 and length: 26973 | Birth data :weight: 82 million, length: 900,000, head circumference: 400. First year of life: 2200 to 38,000 infants. |
n < 30 weeks | 4101 | 0 | 274 | N/A |
Gestational age range of study | 22 to 43 weeks | 28.5 to 42.5 weeks | 22 to 43 weeks | Post term |
Inclusion criteria | All births | "Healthy" newborn infants | Singleton livebirths | NHANES surveys |
Exclusion criteria | Ontario (province) was excluded due to problems with data quality. | Stillbirths, twins, complications during pregnancy with potential effects on fetal growth and significant malformations | Multiple births | Infants with birthweights < 1500 grams |
Dates | 1994 to 1996 | 1977 to 81 | 1982 to 1995 | Primarily 1963 to 1994 |
Completed gestational weeks | yes | yes | yes | N/A |
Method to assess gestational age | "early ultrasound has increasingly been the basis for gestational age assessments in recent years" | Last menstrual period was used when it was in agreement (+/- 2 weeks) with the obstetric assessment. If not, the latter was used. When either estimate was missing the gestational age was considered unknown. | In the majority of cases the gestational age was based on first trimester ultrasound, or when early ultrasound was not available, last menstrual period dates were used. In < 1% of cases, the Ballard assessment was used when neither dates nor ultrasound were available. | N/A |
Outliers | Assumed a log normal distribution of birthweight at each gestational age and compared the probabilities of accurate versus misclassification of infant's gestational age. | Â | The mother's medical record was examined and following verification of the gestational age and other data, outliers were either accepted as real or corrected. | Curves were smoothed with a variety of parametric and non-parametric procedures |