Grant: Project Grant

The goal of the proposed project is to identify newborn birth weight-for-gestational age values (and related indices) that will distinguish babies at low versus high risk for severe illness or death. The Gates funded INTERGROWTH-21st Project recently developed a birth weight-for-gestational age standard using rigorous design and analysis techniques. However, our studies show that this standard yields unexpected results and is very different from the reference currently used in Canada. We propose to adapt the INTERGROWTH standard for Canada by identifying the birth weight-for-gestational age centiles of this standard that distinguish babies at low vs high risk for illness and death. We will also evaluate how well these birth weight cut-offs perform in practice. Information on all singleton live births in Canada and the United States will be included in the study with information obtained from large perinatal databases. We will use an outcome-based methodology, which we have previously developed, to identify the birth weight at each gestational age at which rates of newborn illness and death are higher than normal. The performance of these cut-offs for identifying high risk babies will be evaluated to ensure that they function optimally in clinical practice in the multi-ethnic Canadian population.