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OBSTETRICS| Volume 34, ISSUE 11, P1026-1037, November 2012

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One Size Does Not Fit All: Differences in Newborn Weight Among Mothers of Philippine and Other East Asian Origin

  • Leanne R. De Souza
    Affiliations
    Institute of Medical Science, University of Toronto, Toronto ON

    Department of Obstetrics and Gynecology, St. Michael’s Hospital, Toronto ON
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  • Marcelo L. Urquia
    Affiliations
    Centre for Research on Inner City Health, St. Michael’s Hospital, University of Toronto, Toronto ON
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  • Michael Sgro
    Affiliations
    Department of Paediatrics, St. Michael’s Hospital, University of Toronto, Toronto ON

    Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto ON
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  • Joel G. Ray
    Affiliations
    Institute of Medical Science, University of Toronto, Toronto ON

    Department of Obstetrics and Gynecology, St. Michael’s Hospital, Toronto ON

    Centre for Research on Inner City Health, St. Michael’s Hospital, University of Toronto, Toronto ON

    Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto ON

    Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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DOI:https://doi.org/10.1016/S1701-2163(16)35432-9
One Size Does Not Fit All: Differences in Newborn Weight Among Mothers of Philippine and Other East Asian Origin
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      Abstract

      Objective

      To determine the likelihood that infants born to Filipina, other East Asian, and Canadian-born women may be misclassified as small for gestational age when using conventional Canadian birth weight curves rather than those specific to their world region.

      Methods

      We conducted a population-based study of 548 418 singleton live births in Ontario between 2002 and 2007. Smoothed birth weight percentile curves were generated for males and females born to women from Canada, the Philippines, and the rest of East Asia/Pacific. We determined the likelihood of misclassifying an infant as small for gestational age (SGA < 10th percentile weight) or large for gestational age (LGA ≥ 90th percentile weight) on a Canadian-born birth weight curve vs. a curve specific to the other two world regions.

      Results

      For gestation-specific 10th and 50th percentiles, term infants born to women from the Philippines often had significantly lower birth weights than infants of Canadian-born mothers. Controlling for maternal age and parity, approximately 88 per 1000 male newborns (95% CI 82 to 95) and 72 per 1000 female newborns (95% CI 54 to 60) of mothers from the Philippines were at risk of being misclassified as SGA. LGA would be missed in approximately 54 per 1000 male newborns (95% CI 49 to 59) and 49 per 1000 female newborns (95% CI 44 to 54) of Filipina mothers. Misclassification of both SGA and LGA was more pronounced among infants of Filipina mothers than of mothers from other East Asian origin.

      Conclusions

      Infants of mothers born in the Philippines weigh significantly less than those of Canadian-born women or mothers emigrating from other East Asian countries. Those who use birth weight curves should consider these differences.

      Résumé

      Objectif

      Déterminer la probabilité que les enfants issus de femmes nées aux Philippines, dans d’autres pays de l’Asie orientale et au Canada puissent être classés par erreur comme présentant une hypotrophie foetale lorsque l’on utilise les courbes de poids de naissance canadiennes conventionnelles, plutôt que les courbes propres à la région de naissance maternelle.

      Méthodes

      Nous avons mené une étude en population générale portant sur 548 418 naissances vivantes à la suite de grossesses monofoetales en Ontario, entre 2002 et 2007. Des courbes lissées de percentile de poids de naissance ont été générées pour les enfants de sexe masculin et de sexe féminin issus de femmes du Canada, des Philippines et du reste de la région Asie orientale/ Pacifique. Nous avons comparé la probabilité de classer par erreur ces enfants comme présentant une hypotrophie foetale (hypo. foetale : poids < 10e percentile) ou une hypertrophie foetale (hyper. foetale : poids ≥ 90e percentile), en fonction d’une courbe de poids de naissance adaptée aux enfants nés au Canada, à la probabilité d’une telle erreur en fonction d’une courbe propre aux deux autres régions mondiales.

      Résultats

      En ce qui concerne le 10e et le 50e percentile propre à la gestation, les enfants nés à terme de femmes provenant des Philippines présentaient souvent des poids de naissance considérablement inférieurs à ceux des enfants issus de mères nées au Canada. À la suite de la neutralisation de l’effet de l’âge maternel et de la parité, près de 88 nouveau-nés sur 1 000 (IC à 95 %, 82 - 95) et de 72 nouveau-nées sur 1 000 (IC à 95 %, 54 - 60) issus de mères provenant des Philippines étaient exposés à un risque d’être classés par erreur comme présentant une hypotrophie foetale. L’hypertrophie foetale passerait inaperçue chez environ 54 nouveau-nés sur 1 000 (IC à 95 %, 49 - 59) et chez 49 nouveau-nées sur 1 000 (IC à 95 %, 44 - 54) issus de mères provenant des Philippines. La classification par erreur des nouveau-nés (tous sexes confondus) comme présentant une hypotrophie foetale ou une hypertrophie foetale était plus prononcée dans le cas des enfants issus de mères provenant des Philippines que dans celui des enfants issus de mères provenant d’autres pays de l’Asie orientale.

      Conclusions

      Les enfants issus de mères nées aux Philippines présentent un poids considérablement inférieur à celui des enfants issus de mères nées au Canada ou dans d’autres pays de l’Asie orientale. Les intervenants qui font appel aux courbes de poids de naissance devraient prendre ces différences en considération.

      Key Words

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      Article info

      Publication history

      Accepted: July 20, 2012
      Received: April 18, 2012

      Footnotes

      Competing Interests: None declared.

      Identification

      DOI: https://doi.org/10.1016/S1701-2163(16)35432-9

      Copyright

      © 2012 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

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