C C128766 GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on certain last menstrual period (LMP) date with confirmatory first or second trimester ultrasound (US) scan, OR uncertain LMP with second trimester ultrasound, intrauterine insemination (IUI), OR embryo transfer, OR certain or uncertain LMP with fundal height and no confirmatory first or second trimester scan; second, HC 2 SD below mean or less than 3 percentile according to fetal US scan using appropriate standardized reference charts according to GA and gender for the population (e.g., WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is in the normal range using appropriate standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. Level 4 Prenatally Diagnosed Congenital Microcephaly Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on certain last menstrual period (LMP) date with confirmatory first or second trimester ultrasound (US) scan, OR uncertain LMP with second trimester ultrasound, intrauterine insemination (IUI), OR embryo transfer, OR certain or uncertain LMP with fundal height and no confirmatory first or second trimester scan; second, HC 2 SD below mean or less than 3 percentile according to fetal US scan using appropriate standardized reference charts according to GA and gender for the population (e.g., WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is in the normal range using appropriate standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology C C128770 GAIA Level 1 Failure to Thrive GAIA Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. Additionally, the following information applies to this term: a. Age: This case definition is limited to infants up to 12 months of age. b. Weight and Length: Weight should be documented on the appropriate growth chart at the time of assessment. A fall through 2 centile spaces may be demonstrated at any point in the first 12 months of life, using any two weights as long as they are taken at least 4 weeks apart. Details of use of the weight balances allowable under this case definition and use of the Infantometer for length assessment are in Appendix A. c. Growth charts: For infants born at 37 weeks gestation or above, the WHO growth charts should be applied. When using weight for age use the growth chart most accurate for the infants age. The birth to 6 months age range should be used where data is available for this range only, the birth to 2 years chart should be used where data is available beyond 6 months of life. When using weight for length, use the chart for birth to 2 years. For infants born less than 37 completed weeks gestation, the Intergrowth charts for postnatal growth standards in preterm infant should be used. All infants should be plotted on their respective growth chart using their corrected age. Links to relevant growth charts can be found in Appendix A (www.gaia-consortium.net). Level 1 Failure to Thrive Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. Additionally, the following information applies to this term: a. Age: This case definition is limited to infants up to 12 months of age. b. Weight and Length: Weight should be documented on the appropriate growth chart at the time of assessment. A fall through 2 centile spaces may be demonstrated at any point in the first 12 months of life, using any two weights as long as they are taken at least 4 weeks apart. Details of use of the weight balances allowable under this case definition and use of the Infantometer for length assessment are in Appendix A. c. Growth charts: For infants born at 37 weeks gestation or above, the WHO growth charts should be applied. When using weight for age use the growth chart most accurate for the infants age. The birth to 6 months age range should be used where data is available for this range only, the birth to 2 years chart should be used where data is available beyond 6 months of life. When using weight for length, use the chart for birth to 2 years. For infants born less than 37 completed weeks gestation, the Intergrowth charts for postnatal growth standards in preterm infant should be used. All infants should be plotted on their respective growth chart using their corrected age. Links to relevant growth charts can be found in Appendix A (www.gaia-consortium.net). C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology