Comparison of updated birth weight,length and head circumference charts by gestational age in China with the INTERGROWTH-21 st NCSS charts:a population-based study

Background INTERGROWTH-21 st Newborn Cross-Sectional Study(NCSS)charts were established and recommended for global application.However,whether one international reference is appropriate for all populations is still unclear.We aim to compare the updated Chinese birth size charts by gestational age with INTERGROWTH-21st NCSS charts.Methods A cross-sectional survey was carried out,and the birth weight,length and head circumference of 24,375 infants born after uncomplicated pregnancies at gestational age ranging from 24+0 to 42+6 weeks were measured in 13 cities in China from 2015 to 2018.Growth charts were constructed.The measurements of all these infants were evaluated by the methods of calculating their Z scores using the INTERGROWTH-21 st standards.The prevalence of small for gestational age(SGA)and large for gestational age(LGA)based on birth weight was analyzed using Chinese charts and INTERGROWTH-21st charts.Results The mean Z scores were 0.10 for birth weight,0.35 for length and-0.02 for head circumference.Compared to the INTERGROWTH-21st charts,the Chinese birth weight percentile curves were higher except for the 90th percentile at 29-37 weeks gestational age,and the length percentile curves were higher after 33 weeks gestational age,while the 10th percentile of the head circumference was lower and the other percentiles were similar.The prevalence of SGA was 10.1%[95%confidence interval(CI)=9.7%-10.5%]using the Chinese birth weight chart and 6.5%(95%CI=6.2%-6.8%)using the INTERGROWTH-21 st birth weight chart.The prevalence of LGA was 9.9%(95%CI=9.5%-10.2%)and 8.2%(95%CI=7.9%-8.6%)using the Chinese and INTERGROWTH-21st birth weight charts,respectively.Conclusions Chinese birth size charts based on infants born after uncomplicated pregnancies were different from the INTER-GROWTH-21st charts.Differences in the classification of newborns by the two charts should receive attention,and whether the application of INTERGROWTH-21st in Chinese newborns will lead to misclassification needs to be validated in future clinical practice.

Automatic Fetal Segmentation Designed on Computer-Aided Detection with Ultrasound Images

In the present research,we describe a computer-aided detection(CAD)method aimed at automatic fetal head circumference(HC)measurement in 2D ultrasonography pictures during all trimesters of pregnancy.The HC might be utilized toward determining gestational age and tracking fetal development.This automated approach is particularly valuable in low-resource settings where access to trained sonographers is limited.The CAD system is divided into two steps:to begin,Haar-like characteristics were extracted from ultrasound pictures in order to train a classifier using random forests to find the fetal skull.We identified the HC using dynamic programming,an elliptical fit,and a Hough transform.The computer-aided detection(CAD)program was well-trained on 999 pictures(HC18 challenge data source),and then verified on 335 photos from all trimesters in an independent test set.A skilled sonographer and an expert in medicine personally marked the test set.We used the crown-rump length(CRL)measurement to calculate the reference gestational age(GA).In the first,second,and third trimesters,the median difference between the standard GA and the GA calculated by the skilled sonographer stayed at 0.7±2.7,0.0±4.5,and 2.0±12.0 days,respectively.The regular duration variance between the baseline GA and the health investigator’s GA remained 1.5±3.0,1.9±5.0,and 4.0±14 a couple of days.The mean variance between the standard GA and the CAD system’s GA remained between 0.5 and 5.0,with an additional variation of 2.9 to 12.5 days.The outcomes reveal that the computer-aided detection(CAD)program outperforms an expert sonographer.When paired with the classifications reported in the literature,the provided system achieves results that are comparable or even better.We have assessed and scheduled this computerized approach for HC evaluation,which includes information from all trimesters of gestation.