Interpretation
On the question of what chart to use to predict SGA, this still remains unclear. In theory, the optimal fetal growth chart will not only accurately detect SGA but will also identify those with adverse outcomes among those to screen positive. A retrospective cohort from New Mexico that included over 1500 women concluded that the Hadlock fetal growth chart was superior to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) race/ethnicity-specific standard for the prediction of both neonatal morbidity and small for gestational age.(15) While another single center retrospective study from Detroit that included 3437 African American mothers, reported that the NICHD race specific weight standard was superior to the Hadlock and other weight charts for the prediction of adverse outcomes in SGA infants.(11) Another study from two institutions compared the Hadlock fetal chart with the NTERGROWTH-21st Century growth and they concluded that although the Hadlock may chart may have a superior ability to predict SGA, none of these charts were accurate predictors of adverse neonatal outcomes.(16)