Anthropometric charts for infants with trisomies 21, 18, or 13 born between 22 weeks gestation and term: the VON charts

Abstract

Data on birth weight for gestational age (GA) are not well described for infants with trisomy 21 (T21), trisomy 18 (T18), or trisomy 13 (T13). We report on anthropometric charts of infants with these conditions using data from the Vermont Oxford Network (VON). Data from a total of 5,147 infants with T21 aged 22-41 weeks, 1,053 infants with T18 aged 22-41 weeks, and 613 infants with T13 aged 22-40 weeks were used to create birth weight for GA charts. Head circumference for GA charts were created for infants with T21 only. Combined-sex charts were generated for infants with T18 or T13 while sex-specific charts were generated for infants with T21. Smoothed centiles were created using LmsChartMaker Pro 2.3. Among the three examined groups, infants with T18 were the most likely to be growth restricted while infants with T21 were the least likely to be growth restricted. The new charts for infants with T21 were also compared to the Lubchenco and Fenton charts and both show frequent misclassification of infants with T21 as small or large for GA. The new charts should prove to be useful, especially for infants with T21, to assist in medical management and guide nutrition care decisions.

Conflict of interest statement

CONFLICT OF INTEREST: Dr. Horbar is the Chief Executive and Scientific Officer of the Vermont Oxford Network. Mr. Carpenter is the Director of Operations and Statistics at the Vermont Oxford Network. Both receive salary from the Vermont Oxford Network. None of the authors have disclosures to report.

Copyright © 2012 Wiley Periodicals, Inc.

Figures

FIGURE 1

Data selection process to construct the birth weight for gestational age VON charts of infants with T21, T18 or T13

FIGURE 2

Sex-specific 3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles for infants with trisomy 21 (A) girls’ centiles of birthweight for gestational age (B) girls’ centiles of head circumference for gestational age (C) boys’ centiles of birthweight for gestational age (D) boys’ centiles of head circumference for gestational age

FIGURE 3

3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles of birth weight for gestational age for (A) infants with trisomy 18 (B) infants with trisomy 13

FIGURE 4

A comparison of the 10th, 50th, and 90th centiles of birth weight for gestational age for male infants with trisomy 21 (solid lines), infants with trisomy 18 (round dotted lines) and infants with trisomy 13 (square dotted lines) [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]

FIGURE 5

Birth weight for gestational age sex-specific curves for the 10th, 50th, & 90th centiles comparing (A) females with trisomy 21, solid lines (B) males with trisomy 21, solid lines; with sex-specific centiles with the square dotted lines representing Lubchenco et al. [1963] centiles and the round dotted lines representing Kramer et al. [2001] centiles. Lubchenco et al. [1963] centiles prior to 24 weeks gestation are not available. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]

FIGURE 6

Head circumference for gestational age sex-specific curves for the 10th, 50th, & 90th centiles comparing females with trisomy 21, dashed lines and males with trisomy 21, solid lines; with Lubchenco et al. [1966] combined-sex curves, square dotted lines. Lubchenco et al. [1966] sex-specific centiles and centiles prior to 24 weeks gestation are not available. [Color figure can be viewed in the online issue, which is available at www.interscience.wiley.com.]