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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) (