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

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.