No abstract

Objective To develop reference curves of estimated fetal weight for a local population in Curitiba, South of Brazil, and compare them with the curves established for other populations. Methods An observational, cross-sectional, retrospective study was conducted. A reference model for estimated fetal weight was developed using a local sample of 2,211 singleton pregnancies with low risk of growth disorders and well-defined gestational age. This model was compared graphically with the Hadlock and Intergrowth 21st curves. Results Reference curves for estimated fetal weight were developed for a local population. The coefficient of determination was R2 = 99.11%, indicating that 99.11% of the fetal weight variations were explained by the model. Compared with Hadlock curves, the 50th, 90th, and 97th percentiles in this model were lower, whereas the 10th percentile nearly overlapped, and the 3rd percentile was slightly higher in the proposed model. The percentiles were higher in the proposed model compared with the Intergrowth 21st curves, particularly for the 3rd, 10th, and 50th percentiles. Conclusion We provide a local reference curve for estimated fetal weight. The proposed model was different from other models, and these differences might be due to the use of different populations for model construction.

Os avanços da biotecnologia oriundos do advento da genética e genômica vêm exigindo crescente esforço reflexivo e regulatório sobre aspectos éticos, bioéticos, de biossegurança e jurídicos, uma vez que a sociedade não pode debelar de regulamentações para manter um equilíbrio entre as pesquisas científicas e a dignidade da pessoa humana. O desafio está em ampliar e democratizar o espaço de debate sobre a bioética diante dos avanços ligados à terapia gênica, que consiste na introdução de genes modificados em outro organismo através da tecnologia do DNA recombinante. Estas práticas ainda requerem esclarecimentos e regulamentações, pois pesquisas desta natureza tem seus riscos inerentes, que podem violar o mais admirável princípio da Bioética e do Biodireito: a autonomia. Portanto, torna-se imprescindível o reconhecimento deste panorama –a sua complexidade e conflitos- que tange a bioética e o direito, diante das lacunas na intepretação e operacionalização da lei para resguardar o direito da pessoa humana em qualquer fase da vida.

Purpose: To compare the performance of a local estimated fetal weight curve with curves established for other populations to predict small for gestational age (SGA) fetuses.Methods: A retrospective and cross-sectional study involving 231 fetuses in which the performance of a local curve (proposed model) was compared with the Hadlock and Intergrowth-21st curves in the prediction of SGA fetuses, by applying them to a population of high-risk pregnant woman with HIV/AIDS. For each model, a receiver operating characteristic curve was adjusted, considering the SGA classification by the neonatal Intergrowth method as the gold standard, and the area under the curve (AUC) was calculated.Results: The models presented linear correlations with each other. The agreement of the proposed model with Hadlock was very good (kappa = 0.83), whereas the proposed model and Intergrowth-21st had moderate agreement (kappa = 0.44). The SGA fetus detection sensitivities of the proposed model and Hadlock were 61.9% and 57.1%, with specificity of 84.1% and 86.2% and accuracy of 80.1% and 81%, respectively, without statistical difference. The sensitivity of the Intergrowth-21st model was 33.3%, while the accuracy was 85.7% and the specificity was 97.4%. The AUC estimated values for the Hadlock, proposed, and Intergrowth-21st models were 0.834, 0.832, and 0.835, respectively. Conclusion:The proposed model and Hadlock were interchangeable in the prediction of SGA fetuses and superior to the Intergrowth-21st model.