{ "release_id": "c7fb95f1d15a7d13", "id": "maternal:intergrowth-21st-fgls", "owner": "maternal", "kind": "study", "slug": "intergrowth-21st-fgls", "name": "INTERGROWTH-21st Fetal Growth Longitudinal Study", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "A study in eight countries that scanned the babies of healthy, low-risk women about every five weeks from 14 weeks of pregnancy until birth, to draw international charts of how a fetus grows. The authors recommend the charts as international standards for reading routine scans.", "summary_technical": "Multicentre, population-based, prospective longitudinal cohort (FGLS), part of the INTERGROWTH-21st Project, in geographically defined urban populations in eight countries. Five ultrasound measures (head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference and femur length) were modelled with fractional polynomials in a multilevel framework to give 3rd to 97th centile curves. Funded by the Bill & Melinda Gates Foundation. One of three growth standards that do not agree (see the bottleneck page). Registry number not read.", "editorial_state": "draft", "last_substantive_edit": "2026-10-14", "last_evidence_check": "2026-10-14", "next_review_due": null, "identifiers": [], "navigation": { "maternal": { "life-stage": [ "pregnancy" ], "care-area": [ "fetal-development" ] } }, "payload": { "design": "Multicentre, population-based, prospective longitudinal cohort. Ultrasound fetal measurements were taken prospectively from 14 weeks 0 days of gestation until birth, about every 5 weeks, in women with adequate health and nutritional status who were at low risk of intrauterine growth restriction.", "drug_phase": null, "registry_statuses": [], "start_date": null, "primary_completion_date": null, "completion_date": null, "results_first_posted": null, "countries": null, "care_setting": null, "stopped_early": null, "enrollment": [ { "count": 4321, "basis": "analyzed", "unit": "women (the analysis population: eligible women with pregnancies without major complications who delivered live singletons without congenital malformations)", "snapshot": "maternal:pubmed-25209488-2026-10-14" } ], "arms": [], "findings": [] }, "content_digest": "ef5ff2b60a781b60301c4e5dcca5bbcddec36eae9da33799933dc4db06a4dae6", "review": { "content_digest": "ef5ff2b60a781b60301c4e5dcca5bbcddec36eae9da33799933dc4db06a4dae6", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-intergrowth-fgls-standards", "owner": "maternal", "subject_entity_id": "maternal:intergrowth-21st-fgls", "category": "descriptive", "statement": "The INTERGROWTH-21st Fetal Growth Longitudinal Study took ultrasound measurements of fetuses from 14 weeks 0 days of gestation until birth in a population-based cohort in eight countries, among women with adequate health and nutrition who were at low risk of growth restriction. Of 13,108 women screened, 4607 were eligible, and 4321 (94% of those eligible) formed the analysis population. For five measures (head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference and femur length) the authors calculated the 3rd, 5th, 10th, 50th, 90th, 95th and 97th centile curves by gestational age, and they recommend them as international standards for fetal growth.", "context": { "id": "maternal:ctx-intergrowth-fgls-fetuses", "label": "Fetuses of women at low risk of growth restriction, eight countries, 14 weeks to birth (INTERGROWTH-21st FGLS)", "recipient": "fetal", "population": "Fetuses of women with reliably dated singleton pregnancies, adequate health and nutritional status and low risk of intrauterine growth restriction. The analysis population was 4321 women with pregnancies without major complications who delivered live singletons without congenital malformations. The women are the people recruited; the fetuses are the people measured.", "care_setting": "Population-based antenatal care in geographically defined urban populations, where most health and nutritional needs of mothers were met", "geography": "Eight countries (the abstract does not name them)", "life_stage_note": "Pregnancy, from 14 weeks 0 days of gestation until birth", "life_stage_terms": { "maternal": [ "pregnancy" ] }, "gestational_age_min_days": 98, "gestational_age_max_days": null, "gestational_age_basis": "at_measurement", "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Ultrasound measurements about every 5 weeks (within 1 week either side) from 14 weeks to 42 weeks of gestation, and birth outcomes", "eligibility": { "inclusion": [ "Gestational age confirmed by ultrasound crown-rump length in the first trimester", "Adequate health and nutritional status; low risk of intrauterine growth restriction" ], "exclusion": [ "Pregnancies with major complications, and babies not born live as singletons or with congenital malformations, were left out of the analysis population" ] } }, "evidence_stage": "observational", "certainty": "not_assessed", "certainty_method": null, "limitations": "This describes how fetuses grew in a selected, low-risk cohort in urban populations where health and nutritional needs were mostly met. It is the authors' recommendation that the curves serve as standards everywhere, and later reviews and studies disagree about whether one standard fits all populations (see the growth standard disagreement page). The abstract does not name the eight countries. PubMed links a published erratum (Lancet 2014;384:1264, a Department of Error notice) that was not read: the record has no PubMed number I could find and the publisher page returned HTTP 403. Funded by the Bill & Melinda Gates Foundation (PubMed abstract). Only the abstract was read. A published correction exists; whether it changes this claim is not known.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, METHODS, sentence 1, fragment 1 of 2", "applicability_note": "PubMed abstract.", "snapshot": { "id": "maternal:pubmed-25209488-2026-10-14", "retrieved_at": "2026-10-14T18:18:26Z", "content_hash": "47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078", "source_effective_date": null, "public_archive_url": null, "source_state": "corrected" }, "source": { "id": "maternal:pubmed-10-1016-s0140-6736-14-61490-2", "source_type": "publication", "title": "International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project", "canonical_url": "https://doi.org/10.1016/S0140-6736(14)61490-2", "identifiers": [ { "scheme": "doi", "value": "10.1016/S0140-6736(14)61490-2", "normalized_value": "10.1016/s0140-6736(14)61490-2", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "25209488", "normalized_value": "25209488", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2014-09-06", "publisher": "Lancet (London, England)", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. 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