Validation of intrauterine growth anthropometric curves: Hospital Vicente Corral, Cuenca, Ecuador, 2013

Abstract

A cross-sectional study was conducted at the Vicente Corral Hospital of Cuenca (Ecuador) in February-August 2013 to assess the intrauterine growth curves according to the Latin American Center for Perinatal Care (CLAP), Olsen, Alarcon-Pittaluga, Battaglia-Lubchenco, Babson-Benda with the objective of identifying the most appropriate anthropometric pattern of fetal growth for the classification of newborns until Ecuador possesses its own patterns. The sample was composed of newborns whose mothers were under age 21. The inclusion criteria were children born alive, with gestational age between 22 and 42 weeks, meeting all anthropometric measures. Children with congenital malformations were disregarded. The sensitivity, specificity and Cohen kappa index of the studied anthropometric curves as weight, height, head circumference and sex of the newborn were evaluated. The curves of CLAP (36.6 to 43.5%) and Olsen’s (37 to 40.9%) identified similar percentages of PEG. Babson-Benda curves detected very few PEG (1.3-2.8%). For the variable weight: Olsen’s curves showed good sensitivity (81.8-97.6%), very good specificity (91.8-97.5%) and kappa index (0.807-0.873). The Alarcon-Pittaluga curve showed very good sensitivity (98.2-99.5%); good specificity (74.9-77.9%) and kappa index (0.707-0.717). The Battaglia-Lubchenco curve showed low sensitivity (40.0-42.8%), very good specificity (99.3-100.0%) and moderate kappa index (0.449-458). Babson-Benda curve presented very low sensitivity (3.5-6.4%), very good specificity (100.0%) and poor kappa index (0.044-0.072). In summary, the anthropometric Olsen’s curves seem to be most adequate and recommended to be used as standard until Ecuador possesses its own curves. It is recommended neither to use the Babson-Benda nor the Battaglia-Lubchenco curves.