Ponderal Index: A Better Definition of the ‘At Risk’ Group With Intrauterine Growth Problems than Birth‐weight for Gestational Age in Term Infants

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Abstract
EDITORIAL COMMENT: This study provides persuasive evidence that estimation of ponderal index provides a worthwhile parameter for assessment of fetal condition in newborn infants. We agree with the authors' conclusions that ponderal index warrants documentation as well as fetal growth retardation using the accepted definition of equal to or less than the tenth percentile for birth‐weight for infants of similar gestational age born in the community concerned. The disadvantage of ponderal index is that it is less useful for the obstetrician making management decisions, since it cannot he calculated before delivery, when clinical and ultrasonographic estimations of fetal growth retardation are available. Ponderal index certainly should be calculated for paediatric follow‐up studies of high risk infants. Hopefully we will be offered further studies on ponderal index versus fetal growth retardation, symmetrical and asymmetrical, as a parameter for assessment of the condition of the newborn infant and the risk of subsequent physical and neurological impairment.Summary: A study was undertaken at Nepean Hospital, Penrith to compare the outcome of pregnancies with growth retarded infants; 2,508 consecutive births were analyzed between August 1, 1989 and April 30, 1990. A comparison of outcome was made between infants whose birth‐weight for gestational age was below the tenth percentile and infants who had a low ponderal index from 37 weeks' gestation. The Caesarean section delivery and fetal distress rates were significantly higher for infants with a low ponderal index than for infants with a low birth‐weight. Ponderal index appears to be a better measure of infants with intrauterine growth problems than birth‐weight percentiles.