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Background <p>Birth weight (BW) is an indicator for the assessment of neonatal health. No recent studies have specifically evaluated the distribution of BW in infants born in Lombardy and no updated regional neonatal charts are available. The aim of this study is to trace region-specific BW charts (CedAP charts) for neonates born in Lombardy and to compare them with the INeS charts, specific for Italian neonates, and with the Intergrowth21st (IG21) international neonatal charts.</p> Methods <p>Data of 361,105 singleton live births were extracted from the certificate of assistance in childbirth (CedAP) registry. The Extended Mechanistic Growth Function method was used to trace CedAP charts. The comparison with the INeS and the IG21 charts was performed by centiles shape, computing z-scores means and standard deviation, and by the proportion of small-for-gestational-age (SGA), appropriate-for-gestational-age (AGA), and large-for-gestational-age (LGA) detected with each chart.</p> Results <p>The CedAP charts are similar to the INeS charts, particularly at lower centiles, while at higher centiles the CedAP charts tend to show slightly higher values. Comparisons with the IG21 charts show more differences. According to INeS charts, the mean BW z-score is close to expected, with minor deviations observed across gestational ages (GA). According to IG21 z-scores, the mean values were negative for preterm classes and positive for term neonates. The SDs are comparable in all the three charts. The proportion of neonates classified as SGA is overestimated in IG21 charts at GA &lt; 33 weeks and underestimated at term. In contrast, the INeS and CedAP classifications are more consistent, with CedAP showing a slight underestimation of SGA at term. The IG21 charts tend to classify fewer preterm neonates as LGA.</p> Conclusion <p>While IG21 represent a useful tool for studies of populations comparison, CedAP and INeS charts may be more appropriate for assessing neonates in Lombardy and throughout all Italy. These findings suggest that the INeS charts remain relevant for clinical practice, CedAP charts providing complementary, region-specific charts. Further studies are needed to assess the clinical predictive performance of different neonatal charts in identifying neonates at risk for adverse outcomes.</p>

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Birth weight distribution of neonates in Lombardy: development of CedAP charts and comparison with national and international charts

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月21日

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  • Sara Tunesi,
  • Elena Spada,
  • Corrado Celata,
  • Antonio Giampiero Russo

摘要

Background

Birth weight (BW) is an indicator for the assessment of neonatal health. No recent studies have specifically evaluated the distribution of BW in infants born in Lombardy and no updated regional neonatal charts are available. The aim of this study is to trace region-specific BW charts (CedAP charts) for neonates born in Lombardy and to compare them with the INeS charts, specific for Italian neonates, and with the Intergrowth21st (IG21) international neonatal charts.

Methods

Data of 361,105 singleton live births were extracted from the certificate of assistance in childbirth (CedAP) registry. The Extended Mechanistic Growth Function method was used to trace CedAP charts. The comparison with the INeS and the IG21 charts was performed by centiles shape, computing z-scores means and standard deviation, and by the proportion of small-for-gestational-age (SGA), appropriate-for-gestational-age (AGA), and large-for-gestational-age (LGA) detected with each chart.

Results

The CedAP charts are similar to the INeS charts, particularly at lower centiles, while at higher centiles the CedAP charts tend to show slightly higher values. Comparisons with the IG21 charts show more differences. According to INeS charts, the mean BW z-score is close to expected, with minor deviations observed across gestational ages (GA). According to IG21 z-scores, the mean values were negative for preterm classes and positive for term neonates. The SDs are comparable in all the three charts. The proportion of neonates classified as SGA is overestimated in IG21 charts at GA < 33 weeks and underestimated at term. In contrast, the INeS and CedAP classifications are more consistent, with CedAP showing a slight underestimation of SGA at term. The IG21 charts tend to classify fewer preterm neonates as LGA.

Conclusion

While IG21 represent a useful tool for studies of populations comparison, CedAP and INeS charts may be more appropriate for assessing neonates in Lombardy and throughout all Italy. These findings suggest that the INeS charts remain relevant for clinical practice, CedAP charts providing complementary, region-specific charts. Further studies are needed to assess the clinical predictive performance of different neonatal charts in identifying neonates at risk for adverse outcomes.