INTERGROWTH-21st

The INTERGROWTH-21st project, coordinated by the University of Oxford’s Maternal and Perinatal Health Institute (OMPHI), was conducted from 2009 to 2014 in eight sites around the world to create international standards for pregnancy dating, fetal growth and newborn size. These tools provide an extension of the World Health Organization (WHO) Child Growth Standards into the early neonatal and fetal period, thus offering a standardized method of assessing growth along the continuum of fetal through early childhood growth and development, which is useful for both providers and patients.

Research from the INTERGROWTH-21st project found that, contrary to previous research, when mothers are healthy, babies around the globe grow at similar rates regardless of race and ethnicity. These findings have significant implications for improving the quality of perinatal research and newborn care. The INTERGROWTH-21st charts provide more accurate guidelines for measuring and classifying newborn growth. Babies who are measured using previous growth charts are often misclassified and, in turn, do not get the care they need. The researchers have estimated that each year, at least 13 million newborns around the world who would be considered normal size based on outdated charts will be identified as undernourished using the more accurate INTERGROWTH-21st standards.

The Maternal Health Task Force (MHTF) partnered with OMPHI to inform policymakers and clinicians of the benefits of using INTERGROWTH-21st charts for newborn health. Through the INTERGROWTH-21st project, the MHTF and OMPHI helped bridge the gap between research and practice by connecting leading researchers, policymakers and program implementers to incorporate INTERGROWTH-21st standards into global efforts to improve newborn health.

Findings from the INTERGROWTH-21ST project:

Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: Analysis of CHERG datasets
BMJ | August 2017

International estimated fetal weight standards of the INTERGROWTH-21st Project
Ultrasound in Obstetrics & Gynecology | March 2017

The antepartum stillbirth syndrome: Risk factors and pregnancy conditions identified from the INTERGROWTH-21st Project
BJOG | December 2016

International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective cohort study in eight countries
BMJ | November 2016

International standards for early fetal size and pregnancy dating based on ultrasound measurement of crown-rump length in the first trimester
Ultrasound in Obstetrics & Gynecology | November 2014

International standards for fetal growth based on serial ultrasound measurements: The Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project
The Lancet | September 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
The Lancet | September 2014

The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: The Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study
The Lancet Diabetes & Endocrinology | July 2014

Special issue: The methodology of the INTERGROWTH‐21st Project
BJOG | September 2013

Translating research into practice: The introduction of the INTERGROWTH-21st package of clinical standards, tools and guidelines into policies, programmes and services
BJOG September 2013

Tools and resources from the INTERGROWTH-21st project:

Preterm infant feeding and growth monitoring: Implementation of the INTERGROWTH-21st protocol, interactive e-Learning course

INTERGROWTH-21st Study Protocols

Learn more about this project on the INTERGROWTH-21st website.