Birth anthropometry among three Asian racial groups in Singapore: proposed new growth charts.

OBJECTIVE: We analysed birth anthropometry of babies of Chinese, Malay and Indian ancestry living in Singapore with an aim to develop gestational age (GA) and gender-specific birth anthropometry charts and compare these with the widely used Fenton charts. DESIGN: Retrospective observational study. SETTING: Department of Neonatology, National University Hospital, Singapore. POPULATION: We report data from 52 220 infants, born between 1991-1997 and 2010-2017 in Singapore. METHODS: Anthropometry charts were built using smoothened centile curves and compared with Fenton's using binomial test. Birth weight (BW), crown-heel length and head circumference (HC) were each modelled with maternal exposures using general additive model. MAIN OUTCOME MEASURES: BW, crown-heel length and HC. RESULTS: There were 22 248 Chinese (43%), 16 006 Malay (31%) and 8543 Indian (16%) babies. Mean BW was 3103 g (95% CI 3096 to 3109), 3075 g (95% CI 3067 to 3083) and 3052 g (95% CI 3041 to 3062) for Chinese, Malays and Indians, respectively. When exposed to a uniform socioeconomic environment, intrauterine growth and birth anthropometry of studied races were almost identical. From our GA-specific anthropometric charts until about late prematurity, Asian growth curves mirrored that of Fenton's; thereafter, Asian babies showed a reduction in growth velocity. CONCLUSIONS: These findings suggest that Asian babies living in relatively uniform socioeconomic strata exhibit similar growth patterns. There is a slowing of growth among Asian babies towards term, prompting review of existing birth anthropometry charts. The proposed charts will increase accuracy of identification of true fetal growth restriction as well as true postnatal growth failure in preterm infants when applied to the appropriate population.

Early neonatal streptococcal infection.

OBJECTIVE: To determine the incidence of early onset Group B Streptococcal (GBS) infection in infants born over a two year period and to determine the outcome of sepsis evaluation in infants born to mothers with GBS colonization. METHODS: The charts of infants born to mothers with GBS colonization were reviewed for details of sepsis evaluation and management. The microbiology records were used to identify proven cases of GBS septicemia and meningitis in neonates born during the study period. RESULTS: Out of a total of 4636 live births in 2 years, there was one infant with culture-proven GBS septicemia, an incidence of 0.2 per 1000 live births. During the study period 83 infants were born to mothers who were known to have GBS carriage at the time of delivery. 73 out of these 83 infants (88%) had sepsis evaluation and received empirical parenteral penicillin for at least 5 days. There were no cases of blood culture-proven GBS sepsis among these 83 infants. However, there were 2 cases of probable sepsis giving an attack rate of 2.4%. All the three infants with definite or probable sepsis were preterm; there were no deaths among these affected infants. CONCLUSION: The overall incidence of early onset GBS sepsis was found to be low when compared to previous reported studies. The strategy of sepsis evaluation and management was found to be effective in preventing death and definite GBS septicemia in infants born to GBS colonized mothers.