Assessing the role of maternal race on the prediction of NICU admission by three growth charts: a cross-sectional study.

Since the NIH standard identified the fewest LGA infants and the Intergrowth 21st standard identified the fewest SGA infants, these charts may have been better identifiers of infants on either extreme of growth. The agreement between NIH and Intergrowth 21st charts suggest their interchangeable use for healthy populations, but the NIH may be more applicable given its racial stratification. However, the differences in proportions of SGA/LGA infants among the three charts according to maternal race introduce significant clinical ambiguity when identifying vulnerable infants. Additionally, no chart was able to accurately identify vulnerable infants and the dataset did not permit differentiation between growth-restricted and constitutionally small infants. Further work is necessary before selecting a true gold standard for use in routine clinical practice.