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American Journal of Epidemiology Advance Access originally published online on March 14, 2008
American Journal of Epidemiology 2008 167(7):786-792; doi:10.1093/aje/kwm327
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

PRACTICE OF EPIDEMIOLOGY

The Missing Data Problem in Birth Weight Percentiles and Thresholds for "Small-for-Gestational-Age"

Jennifer A. Hutcheon1 and Robert W. Platt1,2

1 Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
2 Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada

Correspondence to Jennifer A. Hutcheon, The Montreal Children's Hospital Research Institute, 4060 Rue Sainte Catherine Ouest #205, Westmount, Quebec, Canada H3Z 2Z3 (e-mail: jennifer.hutcheon{at}mail.mcgill.ca).

Received for publication August 10, 2007. Accepted for publication October 9, 2007.

Weight-for-gestational-age charts and definitions of "small-for-gestational-age" based on the distribution of livebirths at a given gestational age have conventionally been used to identify infants whose fetal growth is poor. However, references based on the weights of only livebirths have serious shortcomings at preterm ages due to missing data on the weights of fetuses still in utero, and these missing data introduce considerable bias to etiologic studies of fetal growth restriction. Application of standard epidemiologic approaches for missing data is needed to help produce perinatal weight percentiles that provide unbiased assessment of fetal growth and risks of small-for-gestational-age.

bias (epidemiology); fetal growth retardation; infant, small for gestational age; reference values

Abbreviations: AGA, appropriate-for-gestational-age; SGA, small-for-gestational-age

Editor's note: An invited commentary on this article appears on page 793, and the authors' response is published on page 797.


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Related articles in Am. J. Epidemiol.:

Invited Commentary: The Hidden Population in Perinatal Epidemiology
Nigel Paneth
Am. J. Epidemiol. 2008 167: 793-796. [Abstract] [FREE Full Text]  

Hutcheon and Platt Respond to "The Hidden Population in Perinatal Epidemiology"
Jennifer A. Hutcheon and Robert W. Platt
Am. J. Epidemiol. 2008 167: 797-798. [Extract] [FREE Full Text]  



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