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CLASSIFICATION OF NEWBORNS (BOTH SEXES) BY INTRAUTERINE GROWTH AND GESTATIONAL AGE1,2 NAME ____________________________________________
DATE OF BIRTH ___________________________________
LENGTH _________________________________________
HOSPITAL NO. _____________________________________
SEX _____________________________________________
HEAD CIRC. ______________________________________
RACE ____________________________________________
BIRTH WEIGHT ____________________________________
GESTATIONAL AGE
4600 4400 4200 4000 3800 3600 3400 3200 3000 2800 2600 2400 2200 2000 1800 1600 1400 1200 1000 800 600 400 0
WEIGHT PERCENTILES
90 75 50 25
Length (cm)
Weight (g)
DATE OF BIRTH ___________________________________
10
PRETERM
TERM
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Gestational Age (week)
54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 0
LENGTH PERCENTILES 90 75 50 25
10
PRETERM
TERM
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Head Circumference (cm)
Gestational Age (week) 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 0
HEAD CIRCUMFERENCE PERCENTILES 90
CLASSIFICATION OF INFANT*
Weight
Length
Head Circ.
75
Large for Gestational Age (LGA) (>90th percentile)
50 25 10
Appropriate for Gestational Age (AGA) (10th to 90th percentile) Small for Gestational Age (SGA) (