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Small babies at term (40 – 42 weeks)

HQMNZ ID: HQM16.6.29.926

Outcome

All maternity services are consistently delivered to the highest standard across NZ.

Measure

Percentage or number of small babies at term born at 40 – 42 weeks gestation

Type

Contributory measure

Relationship(s) to other frameworks

Ministry of Health. 2015. New Zealand Maternity Clinical Indicators 2013. Wellington: Ministry of Health.

Rationale

Infants who are born small for gestational age (SGA) are at increased risk of neonatal morbidity and mortality, reduced growth through childhood, lower childhood neurodevelopmental scores, reduced educational attainment and increased lifetime risk for impaired glucose tolerance, including type 2 diabetes, and cardiovascular disease (Arcangeli et al 2012; Lawn et al 2014).

Placental disease (including that associated with pre-eclampsia) and smoking are common causes of poor fetal growth leading to SGA babies. Appropriate management of women at increased risk of SGA (those with a past history of SGA, hypertension or obesity, and those who smoke) may reduce the risk. Timely detection of poor fetal growth may reduce the risk of stillbirth by presenting the opportunity for enhanced surveillance and iatrogenic early birth.

This indicator measures the proportion of SGA babies at term gestation (37–42 weeks) that were born at 40–42 weeks’ gestation. This indicator is intended to drive review of clinical practice management for the identification and management of poor fetal growth at term. Evidence/best practice recommends the expedited birth of babies identified as SGA once they reach term, and ideally before 40 weeks; therefore, this indicator represents the proportion of unrecognised or sub-optimally managed cases.


Eligible population

Live-born babies born at 37–42 weeks’ gestation with birthweight under the 10th centile for their gestation and sex.

Measure status

Active

Numerator

Total number of babies born at 40–42 weeks’ gestation with birthweight under the 10th centile for their gestation.

Denominator

Total number of babies born at 37–42 weeks’ gestation with birthweight under the 10th centile for their gestation.

National target

N/A

Local target

Milestones to be decided by Alliance

Data Sources

National Maternity Collection, Mortality Collection, INTERGROWTH-21 growth charts

Data extracted from data sources

MAT, fact mat agg birth

  • National Health Index (NHI) number
  • Baby date of birth
  • Birth key
  • Baby birth status
  • Gestational age
  • Birthweight
  • Sex


Mortality Collection

  • NHI number
  • Baby date of birth

INTERGROWTH-21 growth charts (Villar J, Ismail LC, Victora CG, et al. 2014. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet 384(9946): 857–68.

  • 10th centile birthweight for male and female babies according to gestational age

Data availability

This measure is reported annually on the Ministry of Health website: www.moh.govt.nz (Search: NZ Maternity Clinical indicators)

Measure calculation process

National Maternity Collection, Mortality Collection, INTERGROWTH-21 growth charts

Relationship(s) to other measures

MAT, fact mat agg birth

  • NHI number
  • Baby date of birth
  • Birth key
  • Baby birth status
  • Gestational age
  • Birthweight
  • Sex


Mortality Collection

  • NHI number
  • Baby date of birth

INTERGROWTH-21 growth charts (Villar J, Ismail LC, Victora CG, et al. 2014. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet 384(9946): 857–68.

  • 10th centile birthweight for male and female babies according to gestational age

Measure development notes

Template: System Level Measure Template