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)