Comparison between New AIIMS growth chart versus Fenton growth chart for classification of small-for-gestational-age neonates at birth: A prospective observational study.

Background: Current opinion is divided on the ideal growth chart for classifying neonates at birth, and few studies have compared the accuracy of Fenton vs New AIIMS Growth Charts for the same. The aim of this study was to compare New All India Institute of Medical Sciences (AIIMS) versus Fenton growth charts for classification of small-for-gestational-age (SGA) neonates at birth and to assess the short term adverse outcomes; neonatal mortality, neonatal intensive care unit (NICU) stay of more than 48 hours; symptomatic polycythemia; symptomatic hypoglycemia and neonatal hyperbilirubinemia requiring phototherapy. Methods: This was a prospective observational study of diagnostic accuracy of New AIIMS and Fenton growth charts. Neonates were classified based on birthweight and gestational age on the two charts and their short-term adverse outcomes compared. Results: Among 600 neonates enrolled in the study, mean (±SD) gestational age was 37.99 (± 1.26) weeks and mean birth weight was 2779.24 (± 453.15) g. 152 neonates (25.3%) were classified as SGA by Fenton, against 82 (13.7%) by New AIIMS charts. Accuracy of New AIIMS Chart in predicting adverse outcomes was 71.50% (95% CI: 67.70% to 75.08%), while for the Fenton Chart was 66.00% (95% CI: 62.05% to 69.79%). Conclusion: The Fenton chart identifies a higher proportion of neonates as SGA compared to New AIIMS growth chart, though their short-term adverse outcomes showed no significant differences.