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Indicator Metadata

NameSmall for Gestational Age Rate
Short/Other Names

Not applicable

DescriptionCrude rate for small for gestational age (SGA)
Interpretation

The in-hospital SGA rate represents the proportion of singleton babies born in a Canadian hospital with a birth weight below the 10th percentile for their gestational age and sex. In other words, babies classified as SGA are smaller than 90% of the babies from a standard reference population of the same gestational age and sex.

Lower rates for this indicator are desirable.

HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories, All provinces/territories except Quebec

Reporting Level/Disaggregation

National, Province/Territory, Region

Indicator Results

https://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick%20Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=029DB170438205AEBCC75B8673CCE822

Identifying Information
NameSmall for Gestational Age Rate
Short/Other Names

Not applicable

Indicator Description and Calculation
DescriptionCrude rate for small for gestational age (SGA)
Calculation: Description

Rate = (Number of live singleton newborns classified as SGA at birth) ÷ (Number of live singleton newborns with a valid birth weight, gestational age and gender) × 100

Unit of Analysis: Discharges from acute care facilities

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - Per 100

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Number of live singleton newborns with a valid birth weight, gestational age and gender
Inclusions:
1. ICD-10-CA in-hospital singleton birth code:

a. A diagnosis code of Z38.0 coded in any position

Exclusions:
1. Non-newborn records

2. Cadaveric donors

3. Invalid birth weight (Weight = blank, 0000, 0001 or ZZZZ)

4. Invalid or out-of-range gestational age (Delivery Gestational Age = blank or ZZ or <22 weeks or >43 weeks)

5. Gender Code not equal to F or M

6. ICD-10-CA multiple births codes:

a. Any newborn record (Entry Code = N with a Z38 diagnosis code) where two or more newborn records are born to the same mother (duplicate Maternal Newborn Chart Number) within 40 days of one another (based on Admission Date) in the same institution (Institution Number) OR

b. Any one ICD-10-CA multiple birth diagnosis code of Z38.3, Z38.4, Z38.5, Z38.6, Z38.7 or Z38.8 coded in any diagnosis field

7. ICD-10-CA abortion or other out-of-hospital birth codes:

a. Any one diagnosis code of P96.4, Z38.1 or Z38.2 coded in any diagnosis field

Numerator

Description:
Number of live singleton newborns classified as SGA at birth
Inclusions:
1. Weight <10th percentile for gestational age and gender category. Standard Canadian birth weights for gestational age by gender charts were used (M. S. Kramer et al., 2001).
Exclusions:
Same as denominator (numerator is a subset of the denominator)

Background, Interpretation and Benchmarks
Rationale

SGA rates continue to vary among provinces/territories. Given this variance, this indicator can be used to inform government planners, policy-makers, health system decision-makers, health care providers, patients and the general public. It can help raise awareness and allow Canada to compare its rates with the rates of other countries.

Interpretation

The in-hospital SGA rate represents the proportion of singleton babies born in a Canadian hospital with a birth weight below the 10th percentile for their gestational age and sex. In other words, babies classified as SGA are smaller than 90% of the babies from a standard reference population of the same gestational age and sex.

Lower rates for this indicator are desirable.

HSP Framework Dimension

Health System Outcomes: Improve health status of Canadians

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Kramer MS, Platt RW, Wen SW, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics. 2001;108(2):e35. http://www.pediatrics.org/cgi/content/full/108/2/e35.

Availability of Data Sources and Results
Data Sources

DAD, HMDB, MED-ÉCHO

Available Data Years

Type of Year:
Fiscal
First Available Year:
2007
Last Available Year:
2014

Geographic Coverage

All provinces/territories, All provinces/territories except Quebec

Reporting Level/Disaggregation

National, Province/Territory, Region

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Quick Stats
URL: https://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick%20Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=029DB170438205AEBCC75B8673CCE822

Updates

Not applicable

Quality Statement
Caveats and Limitations

In order to provide a more stable rate estimate, only data from regions with a population of at least 50,000 was reported. Additional reasons for suppression were privacy, rate instability and under-reporting.

Trending Issues

Results are presented for a patient's region of residence, rather than the location of the facility where hospitalization occurred. For P.E.I. and the territories, the entire province/territory is included as a region. Health regions in Nova Scotia and Alberta have changed over time. The Postal Code Conversion File (PCCF/PCCF+) was used to assign patients to their region of residence.

Comments

Standard Canadian birth weights for gestational age by gender charts were used (M. S. Kramer et al., 2001).