Abdominal Circumference Alone versus Estimated Fetal Weight after 24 Weeks to Predict Small or Large for Gestational Age at Birth: A Meta-Analysis

Blue, Nathan R.; Yordan, Jose M. Perez; Holbrook, Bradley D.; Nirgudkar, Pranita; Mozurkewich, Ellen

doi:10.1055/s-0037-1604059

Cited by 35 publications

(4 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Abdominal circumference above the 90 th -centile has higher negative predictive value in detecting LGA than the estimation of fetal weight, which allows the obstetrician to plan the route of delivery with higher accuracy. Our results are not in concordance with Blue, who observed that after the 24 th week of gestation AC measurement has no advantage in the LGA risk assessment in fetuses with estimated overgrowth [14]. Caradeux has not confirmed the effectiveness of longitudinal growth assessment as a better method to detect excessive growth compared to standard biometric measurements [15].…”

Section: Discussioncontrasting

confidence: 99%

Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

et al. 2021

View full text Add to dashboard Cite

Objectives: Growth disorders are frequent in diabetic pregnancies. However, they are difficult to predict and capture early during pregnancy. These newborns are at risk of obesity, diabetes, and cardiovascular disease. While developing, fetal growth abnormalities are typically progressive. Therefore, capturing the earliest moment when they emerge is essential to guide subsequent obstetric management. Material and methods: We aimed to analyze fetal ultrasound growth trajectories in type 1 diabetics. Moreover, we aimed to establish time points when first ultrasound manifestations of fetal growth abnormalities appear and to identify factors that affect fetal growth in women with diabetes. We collected clinical and ultrasound data from 200 patients with PGDM managed in the third-referential centre for diabetes in pregnancy. During every visit, patients underwent an ultrasound examination according to a standard protocol giving 1072 ultrasound scan's records. Every ultrasound consisted of fetal weight estimation, according to the Hadlock 3 formula. Retrospectively patients were divided into three groups depending on neonatal weight. In the group of 200 patients, 60 (30%) delivered LGA and 9 (4.5%) SGA newborns. Results: Fetal growth trajectories show different patterns among fetuses with growth abnormalities in women with type 1 diabetes. The moment, when fetal growth curves diverge, seems to take place in the second trimester, just after the 23 rd week of gestation. Conclusions: It suggests that fetal growth abnormalities in type 1 diabetes may have its roots much earlier than expected. In the first trimester, there were differences in LDL-cholesterol, total cholesterol, triglyceride levels and in insulin requirements between AGA, SGA and LGA subgroups.

show abstract

Section: Discussioncontrasting

confidence: 99%

Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…20 The ability of AC to accurately detect SGA has been evaluated before. In a meta-analysis, Blue et al 21 compared the ability of AC and EFW to predict SGA at birth and found AC <10 th percentile and EFW <10 th percentile to be comparable. Most recently, Caradeux and collaborators performed another systematic review and meta-analysis that found results similar to Blue's group.…”

Section: Discussionmentioning

confidence: 99%

Impact of Using Abdominal Circumference Independently in the Diagnosis of Fetal Growth Restriction

Pressman

Odibo

Duncan

et al. 2021

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objective-Society for Maternal-Fetal Medicine guidelines for diagnosing fetal growth restriction (FGR) have broadened the definition to include abdominal circumference (AC) <10 th percentile for gestational age (GA) regardless of estimated fetal weight (EFW). We aimed to compare the ability of three definitions of FGR to predict small for gestational age (SGA) neonates and adverse outcomes.Methods-We performed a secondary analysis of a prospective cohort of patients who underwent assessment of fetal growth between GA of 26 and 36 weeks. We compared three definitions of FGR: EFW <10 th percentile; AC <10 th percentile; either EFW or AC <10 th percentile. The primary outcome was successful prediction of neonatal SGA. Secondary outcomes included a composite adverse neonatal outcome (CANO). We further compared these definitions of FGR using area under receiver operative curves (AUC) to measure their discriminatory abilities.Results-About 1054 women met inclusion criteria. Ninety-one (8.6%) had EFW <10 th percentile, 122 (11.6%) had AC <10 th percentile, and 137 (12.9%) had either EFW or AC <10 th percentile. SGA was seen in 139 (13.2%); CANO was seen in 139 (13.2%). Ability for detecting neonatal SGA was significantly better when the definition included both EFW or AC <10 th percentile compared to either variable independently. The AUC were: 0.74, 0.73, 0.69; P = .0003. There was no statistical significance in ability for predicting CANO (AUC 0.51, 0.51, 0.50; P = .7447).Conclusions-Addition of AC as a criterion for diagnosing FGR improves our ability to predict neonatal SGA compared to using EFW alone. All three definitions were poorly predictive of neonates at risk for adverse outcomes.

show abstract

“…EFW <10th percentile is recommended by the American College of Obstetricians and Gynecologists [18] and Royal College of Obstetricians and Gynaecologists [19] as the optimum method for diagnosing a SGA fetus; this is supported by a recent systematic review. [20] If the baby is SGA and the Doppler test is normal, further care of the pregnant woman should remain at district or regional hospital level. As the woman is at risk of pre-eclampsia, she should be followed up at least every second week to measure her blood pressure and to test for protein with urine test strips.…”

Section: How Does One Manage Poor Fetal Growth?mentioning

confidence: 99%

‘Reds flags’ in antenatal care: Fetal movements and fetal growth

Gebhardt

2018

S Afr Med J

View full text Add to dashboard Cite

What is the problem? Recently, there has been a growing awareness that poor fetal growth in the third trimester is an important cause of late stillbirth or intrapartum-related adverse outcomes, such as neonatal encephalopathy. During 2014-2016, 63 968 stillbirths were recorded in South Africa (SA). [1] Of those where no apparent cause could be found, 33% occurred at term, while 48% of unexplained stillbirths occurred in women with no obvious obstetric complications. The majority (72%) of babies who died during labour because of presumed intrapartum asphyxia, were infants of low-risk mothers who had no known risk factors. Modifiable factors for intrapartum asphyxia include a prolonged second stage of labour and an apparent inability to detect fetal distress. With regard to patient-related modifiable factors, there were clinical notes relating to reduced fetal movements a few days before fetal death in almost 13 000 cases. However, can a timeous and appropriate response by a mother to decreased fetal movements prevent a late intrauterine death? Is it possible to detect late fetal growth restriction (LFGR) in a low-resourced setting and is there any action that can be taken to reduce risk of death? This article reviews the most recent literature and proposes a simplified management protocol. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

show abstract

Abdominal Circumference Alone versus Estimated Fetal Weight after 24 Weeks to Predict Small or Large for Gestational Age at Birth: A Meta-Analysis

Cited by 35 publications

References 78 publications

Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

Fetal growth trajectory in type 1 pregestational diabetes (PGDM) — an ultrasound study

Impact of Using Abdominal Circumference Independently in the Diagnosis of Fetal Growth Restriction

‘Reds flags’ in antenatal care: Fetal movements and fetal growth

Contact Info

Product

Resources

About