A clinician explains the role of customised growth charts in detecting growth restriction. Which single advantage do they offer?

Answer: D. They adjust for maternal characteristics to better distinguish constitutionally small from truly restricted fetuses

Customised growth charts

Population growth charts do not account for individual maternal factors that legitimately affect fetal size.

Advantage

• Customised charts adjust for maternal characteristics (such as height, weight, parity and ethnicity) to define an expected growth trajectory for that pregnancy.
• This improves the distinction between a constitutionally small but healthy fetus and one that is truly growth restricted.

Use

• Plotting serial estimated fetal weight (or symphysio-fundal height) on a customised chart highlights fetuses that fall away from their expected centile (growth velocity), prompting Doppler and closer surveillance.

The goal is to detect true restriction while avoiding unnecessary intervention for healthy small babies.