Comparing the relation between ultrasound-estimated fetal weight and birthweight in cohort of small-for-gestational-age fetuses.
Adult
Birth Weight
/ physiology
Cohort Studies
Confidence Intervals
Databases, Factual
Female
Fetal Development
Fetal Weight
/ physiology
Humans
Infant, Newborn
Infant, Small for Gestational Age
/ growth & development
Pregnancy
Pregnancy Trimester, Third
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Prenatal
United Kingdom
Young Adult
fetal growth
fetal growth restriction
fetal size
in utero compromise
small for gestational age
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
22
01
2019
revised:
07
05
2019
accepted:
10
05
2019
pubmed:
16
5
2019
medline:
1
4
2020
entrez:
16
5
2019
Statut:
ppublish
Résumé
Small-for-gestational-age (SGA) confers a higher perinatal risk of adverse outcomes. Birthweight cannot be accurately measured until delivery, therefore accurate estimated fetal weight (EFW) based on ultrasonography is important in identifying this high-risk population. We aimed to establish the sensitivity of detecting SGA infants antenatally in a unit with a selective third-trimester ultrasound policy and to investigate the association between EFW and birthweight in these babies. A retrospective cohort study was conducted on non-anomalous singleton pregnancies delivered after 36 weeks of gestation where SGA (<10th percentile) was diagnosed at delivery. The EFW at the time of the third-trimester ultrasound scan was recorded using standard Hadlock formulae. In 2017, there were 8392 non-anomalous singleton pregnancies live born after 36 weeks, excluding late bookers. 797 were live-born SGA <10th percentile for birthweight and 464 <5th percentile, who met our inclusion criteria. The antenatal detection rate of SGA was 19.6% for babies with birthweight <10th percentile and 24.1% <5th percentile. There was a significant correlation between the EFW and birthweight of fetuses undergoing ultrasound assessment within 2 weeks of delivery (P < .001, r = 0.73 (Pearson correlation). For these cases, EFW was greater than the birthweight in 65% of cases. After adjusting all EFWs using the discrepancy between EFW and actual birthweight for those babies born within 48 hours of the scan, the mean difference between the birthweight and adjusted EFW 7 days before delivery was 111 g (95% CI 87-136 g) and at 14 days was 200 g (95% CI 153-248 g). Despite adjusting the EFW, 61/213 cases (28.6%) apparently lost weight between the ultrasound scan and delivery. Small-for-gestational-age infants with a birthweight <10th percentile are poorly identified antenatally with little improvement for those <5th percentile. In SGA babies, ultrasound EFW overestimated birthweight. Discrepancies between birthweight and EFW are not explicable only by the limitations of third-trimester sonography, a reduction in fetal weight close to delivery in a proportion of liveborn SGA babies is plausible.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1435-1441Informations de copyright
© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.
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