Association of third-trimester abdominal circumference with provider-initiated preterm delivery

Hawkins, L.K.; Schnettler, William T.; Modest, Anna M.; Hacker, Michele R.

doi:10.3109/14767058.2013.852171

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…For fetuses delivered preterm, the SGA screen positive rate was significantly higher than 10% for all standards, with the GROW and PRB/NICHD customized standards classifying 26.3% and 29% of the preterm population as being at risk, respectively. This finding is consistent with previous reports showing that SGA fetuses are at an increased risk of a preterm delivery 74, 75 . The rate of fetuses classified as SGA (<10 th centile) in women who delivered at term was close to 10% for the WHO and GROW standards, and significantly higher than 10% for the PRB/NICHD (11.6%) and lower for the NICHD African American (5.3%) standards.…”

Section: Commentsupporting

confidence: 93%

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

Tarca

Romero

Gudicha

et al. 2018

American Journal of Obstetrics and Gynecology

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Background The assessment of fetal growth disorders requires a standard. Current nomograms for the assessment of fetal growth in African American women have been derived either from neonatal (rather than fetal) biometry data or have not been customized for maternal ethnicity, weight, height, parity, and fetal sex. Objective We sought to 1) develop a new customized fetal growth standard for African American mothers; and 2) compare such a standard to three existing standards for the classification of fetuses as small (SGA) or large (LGA) for gestational age. Study Design A retrospective cohort study included 4,183 women (4,001 African American and 182 Caucasian) from the Detroit metropolitan area who underwent ultrasound examinations between 14 and 40 weeks of gestation (the median number of scans per pregnancy was 5, interquartile range 3-7) and for whom relevant covariate data were available. Longitudinal quantile regression was used to build models defining the “normal” estimated fetal weight (EFW) centiles for gestational age in African American women, adjusted for maternal height, weight, parity, and fetal sex, and excluding pathologic factors with a significant effect on fetal weight. The resulting Perinatology Research Branch/Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, PRB/NICHD) growth standard was compared to 3 other existing standards—the customized gestation-related optimal weight (GROW) standard; the Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, NICHD) African American standard; and the multinational World Health Organization (WHO) standard—utilized to screen fetuses for SGA (<10th centile) or LGA (>90th centile) based on the last available ultrasound examination for each pregnancy. Results 1) First, the mean birthweight at 40 weeks was 133g higher for neonates born to Caucasian than to African American mothers and 150g higher for male than female neonates; maternal weight, height, and parity had a positive effect on birthweight.Second, analysis of longitudinal EFW revealed the following features of fetal growth: (1) all weight centiles were about 2% higher for male than for female fetuses; (2) maternal height had a positive effect on EFW, with larger fetuses being affected more (2% increase in the 95th centile of weight for each 10-cm increase in height); and (3) maternal weight and parity had a positive effect on EFW that increased with gestation and varied among the weight centiles. Third, the screen-positive rate for SGA was 7.2% for the NICHD African American standard, 12.3% for the GROW standard, 13% for the WHO standard customized by fetal sex, and 14.4% for the PRB/NICHD customized standard. For all standards, the screen-positive rate for SGA was at least two-fold higher among fetuses delivered preterm than at term.Fourth, the screen-positive rate for LGA was 8.7% for the GROW standard, 9.2% for the PRB/NICHD customized standard, 10.8% for the WHO standard customized by fetal sex, and 12.3% ...

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Section: Commentsupporting

confidence: 93%

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

Tarca

Romero

Gudicha

et al. 2018

American Journal of Obstetrics and Gynecology

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“…Third-trimester fetal ultrasound (US) is a helpful tool to predict neonatal outcomes. In the healthy pregnant population, estimated fetal weight (FW) was found to predict birth weight [ 6 ], whereas lower FW and fetal abdominal circumference (FAC) were associated with preterm birth [ 7 , 8 ]. There is a need for studies investigating the association between third-trimester fetal parameters and diverse adverse neonatal outcomes in the context of a population with GDM.…”

Section: Introductionmentioning

confidence: 99%

Main Fetal Predictors of Adverse Neonatal Outcomes in Pregnancies with Gestational Diabetes Mellitus

Antoniou

Gilbert

Gross

et al. 2020

JCM

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The objectives of this study were to (a) assess the utility of fetal anthropometric variables to predict the most relevant adverse neonatal outcomes in a treated population with gestational diabetes mellitus (GDM) beyond the known impact of maternal anthropometric and metabolic parameters and (b) to identify the most important fetal predictors. A total of 189 patients with GDM were included. The fetal predictors included sonographically assessed fetal weight centile (FWC), FWC > 90% and <10%, and fetal abdominal circumference centile (FACC), FACC > 90% and < 10%, at 29 0/7 to 35 6/7 weeks. Neonatal outcomes comprising neonatal weight centile (NWC), large and small for gestational age (LGA, SGA), hypoglycemia, prematurity, hospitalization for neonatal complication, and (emergency) cesarean section were evaluated. Regression analyses were conducted. Fetal variables predicted anthropometric neonatal outcomes, prematurity, cesarean section and emergency cesarean section. These associations were independent of maternal anthropometric and metabolic predictors, with the exception of cesarean section. FWC was the most significant predictor for NWC, LGA and SGA, while FACC was the most significant predictor for prematurity and FACC > 90% for emergency cesarean section. In women with GDM, third-trimester fetal anthropometric parameters have an important role in predicting adverse neonatal outcomes beyond the impact of maternal predictors.

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“…In a retrospective study including 2237 term and 455 preterm patients, an AC lower than the 5th centile was also found to be associated with composite morbidity and mortality defined as hypoxic-ischemia encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, sepsis, renal failure, or death (adjusted OR (95% CI), 3.77 (1.35–10.5) for term deliveries; and 3.46 (1.89–6.32) for preterm deliveries) [ 26 ]. According to a retrospective study including 592 pregnant women from 28 + 0 to 33 + 6 weeks gestation, small AC was associated with a higher rate of indicated preterm delivery compared to the normal AC group (RR (95% CI), 3.7 (1.8–75), p = 0.002) [ 27 ]. In our study, we included 2790 women >32 + 0 weeks gestation who were expecting to deliver vaginally and demonstrated a significant association between a smaller gestational age according to AC (compared to BPD) and placental abruption, which is one of the important causes of adverse neonatal outcomes and an indication of preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

Can a Difference in Gestational Age According to Biparietal Diameter and Abdominal Circumference Predict Intrapartum Placental Abruption?

Hong

Kim

et al. 2021

JCM

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This study aimed to investigate whether a difference in gestational age according to biparietal diameter (BPD) and abdominal circumference (AC) could be a clinically useful predictor of placental abruption during the intrapartum period. This retrospective cohort study was based on singletons who were delivered after 32 + 0 weeks between July 2015 and July 2020. We only included cases with at least two antepartum sonographies available within 4 weeks of delivery (n = 2790). We divided the study population into two groups according to the presence or absence of placental abruption and compared the clinical variables. The incidence of placental abruption was 2.0% (56/2790) and was associated with an older maternal age, a higher rate of preeclampsia, and being small for the gestational age. A difference of >2 weeks in gestational age according to BPD and AC occurred at a higher rate in the placental abruption group compared to the no abruption group (>2 weeks, 21.4% (12/56) vs. 7.5% (205/2734), p < 0.001; >3 weeks, 12.5% (7/56) vs. 2.0% (56/2734), p < 0.001). Logistic regression analysis revealed that the differences of >2 weeks and >3 weeks were both independent risk factors for placental abruption (odds ratio (OR) (95% confidence interval), 2.289 (1.140–4.600) and 3.918 (1.517–9.771), respectively) after adjusting for maternal age, preeclampsia, and small for gestational age births. We identified that a difference in gestational age of >2 weeks between BPD and AC could be an independent predictor of placental abruption.

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Association of third-trimester abdominal circumference with provider-initiated preterm delivery

Cited by 5 publications

References 22 publications

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study

Main Fetal Predictors of Adverse Neonatal Outcomes in Pregnancies with Gestational Diabetes Mellitus

Can a Difference in Gestational Age According to Biparietal Diameter and Abdominal Circumference Predict Intrapartum Placental Abruption?

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