Our formula, designed for our Reunionese population (Creole people mainly from African and some Indian descent) is probably not adaptable everywhere. As a matter of fact, MFCS is based on the NEONATAL population. SGA/LGA limits are specific for different ethnicities (Indians, Chinese, Eastern Asians, Africans, Polynesian Maoris and others). For example, in India, the SGA limit at term is 2200g, and not approximately 2500g as it is in Reunion. A recent WHO publication proposed even that the universal definition of low birthweight (below 2500g) is ill adapted for all continents: it should be 2200g in Africa, 2200g in Latin America and 2100g in Asia.
Countries like India, China or Japan have a high rate of lean women. In our formula, lean women of 18.5 kg/m² should have an optGWG of 20 kg (instead of 12.5-18 kg, IOM 2009 recommendations). Are those 20 kg adapted for Indian women? We cannot answer as we do not know Indian newborns’ SGA- LGA definitions. It is the same problem when considering large for gestational age LGA newborns (whatever the gestational age). Considering the specific problem of macrosomic newborns at term (BW ≥ 4000g), in Reunion they represent 3.9% of term babies, but it is 0.5% in India, 6.9% in China, 2.0% in Niger, 2.2% in Thailand, 9.3% in Paraguay 1.3% in Philippines, Nepal, Sri-Lanka and others.
Author(s) Details:
Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, La Réunion, France and Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, La Réunion, France.