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INTERGROWTH-21st Fetal Growth Longitudinal Study

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.

  • Study
  • In this atlas

Overview

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.
Phase
Not reported
Enrolled
  • 4,321 women (the analysis population: eligible women with pregnancies without major complications who delivered live singletons without congenital malformations) (analyzed count) (International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project, retrieved )
Sponsor
Not recorded
Funder
Registry
Not reported
Started
Not reported
Primary completion
Not reported
Completion
Not reported
Countries
Not reported
Care setting
Not reported
Registry status
Not reported

Technical summary

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.

Arms

Not reported

Findings

No findings are published for this study.

Claims and evidence

Context 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
Pregnancy, from 14 weeks 0 days of gestation until birth
Gestational age
at least 14 weeks 0 days (98 days), measured at the time of measurement
Postnatal age
Not reported
Follow-up
Ultrasound measurements about every 5 weeks (within 1 week either side) from 14 weeks to 42 weeks of gestation, and birth outcomes
Eligibility: 2 inclusion criteria; 1 exclusion criterion
Included
  • Gestational age confirmed by ultrasound crown-rump length in the first trimester
  • Adequate health and nutritional status; low risk of intrauterine growth restriction
Excluded
  • Pregnancies with major complications, and babies not born live as singletons or with congenital malformations, were left out of the analysis population

  • Description Observational Certainty not assessed

    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.

    Source problem. A cited source is corrected. Check the sources before relying on this claim.

    Applies to Fetal
    • 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.
    • Population-based antenatal care in geographically defined urban populations, where most health and nutritional needs of mothers were met
    • Eight countries (the abstract does not name them)
    • Pregnancy, from 14 weeks 0 days of gestation until birth
    • Gestational age at least 14 weeks 0 days, measured at the time of measurement
    • Postnatal age Not reported
    Follow-up Ultrasound measurements about every 5 weeks (within 1 week either side) from 14 weeks to 42 weeks of gestation, and birth outcomes
    Certainty method
    Not assessed
    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.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (11)

    1. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, METHODS, sentence 1, fragment 1 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, METHODS, sentence 2, fragment 1 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, METHODS, sentence 2, fragment 2 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, METHODS, sentence 4, fragment 1 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, METHODS, sentence 4, fragment 2 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    6. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, FINDINGS, sentence 1
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    7. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, FINDINGS, sentence 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    8. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, FINDINGS, sentence 5, fragment 1 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    9. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, FINDINGS, sentence 5, fragment 2 of 2
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    10. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, INTERPRETATION, sentence 1
      How it applies
      PubMed abstract.
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      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    11. Supports International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

      Publication · Lancet (London, England) · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2014-09-06 · DOI: 10.1016/S0140-6736(14)61490-2 · PMID: 25209488

      Locator
      Abstract, FUNDING, sentence 1
      How it applies
      PubMed abstract.
      Retrieved
      Source effective date
      Not reported
      Source state
      Corrected
      Snapshot hash
      47e08d8d73ad449d414f5c7bf69c5f255a00b40f0281746fc26cfba949101078
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Record details

Record id
maternal:intergrowth-21st-fgls
Content hash
ef5ff2b60a781b60301c4e5dcca5bbcddec36eae9da33799933dc4db06a4dae6