Customised antenatal growth charts are designed to facilitate better supervision of fetal growth. The chart is printed out in early pregnancy, after confirmation of pregnancy dates, and allows serial plotting of fundal height measurement as well as ultrasound derived estimated fetal weight. Their use increases the antenatal detection of growth problems while reducing the number of unnecessary (false positive) investigations (Gardosi & Francis, 1999)

The latest version of the software programme to produce the customised charts ('GROW' = Gestation Related Optimal Weight: version 4.6) is available for free download from Gestation.Net. The site also has a link to GROW Info with full details and references concerning the software.

A. Evidence for an individually adjustable standard to assess birth weight:

1.  Large proportion of population are currently misclassified (SGA, LGA)

Gardosi J et al. (1992). “Customised antenatal growth charts.” Lancet 339: 283-287, Abstract.

2. Adjusted birth weight percentiles are better correlated with neonatal morphometry 

Sanderson DA et al. (1994). The individualized birth weight ratio: a new method of identifying intrauterine growth retardation.” Br J Obstet Gynaecol 101: 310-314, Abstract.

3. Adjusted birth weight percentiles are better correlated with adverse pregnancy events 

Sciscione AC et al. (1996). Adjustment of birth weight standards for maternal and infant characteristics improves the prediction of outcome in the small-for-gestational-age infant. Am J Obstet Gynecol 175: 544-7, Abstract.

de Jong CLD et al. (1998). “Application of a customised birthweight standard in the assessment of perinatal outcome in a high risk population.” Br J Obstet Gynaecol 105: 531 - 35, Abstract.

Clausson B et al. (2001). Perinatal outcome in SGA births defined by customised versus population based birthweight standards. Br J Obstet Gynaecol 108: 830-4, Abstract.

B. Evidence for an individually adjusted standard to assess fetal growth:

1. Growth curves reproduce birth weight differences in physiological categories in low risk pregnancies 

Mongelli M and Gardosi J (1995). Longitudinal study of fetal growth in subgroups of a low risk population. Ultrasound in Obstetrics & Gynecology 6: 340-344, Abstract.

2. Growth curves reproduce birth weight differences in physiological categories in high risk pregnancies

de Jong CLD et al (1998). Fetal weight gain in a serially scanned high-risk population. Ultrasound in Obstetrics & Gynecology 11: 39-43, Abstract.

3. Customised limits for fetal weight gain reduce false-positive ‘IUGR’ in a normal population 

Mongelli M and Gardosi J (1996). “Reduction of false-positive diagnosis of fetal growth restriction by application of customized fetal growth standards". Obstetrics & Gynecology 88: 844-848, Abstract.

C. Pilot study of feasibility of using customised charts for growth screening

Customised limits for fundal height improve the detection of small for gestational babies and reduce unnecessary investigations

Gardosi J & Francis A (1999). Controlled trial of fundal height measurement plotted on customised antenatal growth charts. Br J  Obstet Gynaecol 106: 309-17, Abstract.

D. Editorial

Leeson S and Aziz N (1997). “Customised fetal growth assessment.” British Journal of Obstetrics & Gynaecology 104: 648-651, Abstract.

Gardosi J (1998). The application of individualised fetal growth curves. J Perinatal Med 26: 137-42, Abstract.

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