Maternal obesity is a potential source of error in mid‐trimester ultrasound estimation of gestational age

Simić, Marija; Wahlin, I. A.; Maršál, Karel; Källén, Karin

doi:10.1002/uog.7502

Cited by 33 publications

(26 citation statements)

References 22 publications

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“…The impact of abdominal fat on image quality was discussed by Simic et al [20]. They concluded that the estimation of gestational age in obese women as being shorter according to ultrasound than according to last menstrual period might be due to erroneous sonographic measurements.…”

Section: Discussionmentioning

confidence: 99%

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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Objective: To estimate the effects of maternal body mass index (BMI) on the sensitivity of detecting fetal anomalies by a routine ultrasound performed either in the first or in the second trimester. Methods: Unselected pregnant women (n = 19,140) were divided into four BMI groups: underweight (<18.5), normal weight (18.5-24.9, reference group), overweight (25.0-29.9), and obese (≥30.0). Fetal anomaly diagnoses were grouped according to their likely clinical consequences as suggested by the Royal College of Obstetricians and Gynaecologists. Minor anomalies were excluded. The detection rate of fetal anomalies in each BMI group was calculated and compared. Results: The prevalence of infants with structural anomalies in the study population was 4% and the prevalence of material obesity was 10%. The detection rates of fetal structural anomalies were 26% for normal-weight, 29% for overweight (odds ratio (OR) 1.15, 95% confidence interval (CI) 0.68-1.95), and 19% for obese women (OR 0.67, 95% CI 0.29-1.52). The detection rate of anomalies with long-term handicap was lower in the obese group (27.3%; OR 0.44, 95% CI 0.11-1.79) compared to normal-weight women (46.3%). Conclusion: The detection rate of fetal anomalies seems to be lower for obese women, but these findings need to be further investigated.

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Section: Discussionmentioning

confidence: 99%

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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“…[25][26][27] Given the potential for such systematic sources of error, 28 we used an algorithm that leverages all available estimates of gestational age to identify records with likely errors in dating.…”

Section: Figurementioning

confidence: 99%

United States Birth Weight Reference Corrected For Implausible Gestational Age Estimates

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Population-based references of birth weight for gestational age are useful indices of birth size in clinical and research settings. WHAT THIS STUDY ADDS:This article uses 2009-2010 US natality data and corrects for likely errors in gestational age dating to yield an up-to-date birth weight for gestational age reference. abstract OBJECTIVES: To provide an updated US birth weight for gestational age reference corrected for likely errors in last menstrual period (LMP)-based gestational age dating, as well as means and SDs, to enable calculation of continuous and categorical measures of birth weight for gestational age. METHODS:From the 2009-2010 US live birth files, we abstracted singleton births between 22 and 44 weeks of gestation with at least 1 nonmissing estimate of gestational age (ie, LMP or obstetric/clinical) and birth weight. Using an algorithm based on birth weight and the concordance between these gestational age estimates, implausible LMPbased gestational age estimates were either excluded or corrected by using the obstetric/clinical estimate. Gestational age-and sex-specific birth weight means, SDs, and smoothed percentiles (3rd, 5th, 10th, 90th, 95th, 97th) were calculated, and the 10th and 90th percentiles were compared with published population-based references.RESULTS: A total of 7 818 201 (99% of eligible) births were included. The LMP-based estimate of gestational age comprised 85% of the dataset, and the obstetric/clinical estimate comprised the remaining 15%. Cut points derived from the current reference identified ∼10% of births as #10th and $90th percentiles at all gestational weeks, whereas cut points derived from previous US-based references captured variable proportions of infants at these thresholds within the preterm and postterm gestational age ranges.CONCLUSIONS: This updated US-based birth weight for gestational age reference corrects for likely errors in gestational age dating and allows for the calculation of categorical and continuous measures of birth size. Pediatrics 2014;133:844-853 AUTHORS:

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“…Studies have shown that last menstrual period and ultrasound may be unreliable, particularly in obese women, although evidence points to a lengthening of the delivery date which would underestimate rather than overestimate gestational age at delivery biasing towards the null with respect to the analyses presented here. 36–37 The primary predictor, prepregnancy weight based on self-report on the birth certificate, has been validated. 38–39 There is some concern that overweight and obese women may underestimate their prepregnancy weight which will lead to an overestimate of weight gain in this population.…”

Section: Commentmentioning

confidence: 99%

Effect of maternal weight on postterm delivery

et al. 2011

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Objective Examine the effect of prepregnancy weight and maternal gestational weight gain on postterm delivery rates. Methods This was a retrospective cohort study of term, singleton births (N=375,003). We performed multivariable analyses of the association between postterm pregnancy and both prepregnancy body mass index (BMI) and maternal weight gain. Results Prolonged or postterm delivery (41 or 42 weeks) was increasingly common with increasing prepregnancy weight (p<0.001) and increasing maternal weight gain (p<0.001). Underweight women were 10% less likely to deliver postterm than normal weight women who gain within the recommendations (aOR 0.90 (95% CI 0.83, 0.97)). Overweight women who gain within or above recommendations were also at increased risk of a 41 week delivery. Finally, obese women were at increased risk of a 41 week delivery with increasing risk with increasing weight (below, within, and above recommendations aOR 1.19, 1.21, and 1.27, respectively). Conclusion Elevated prepregnancy weight and weight gain both increase the risk of a postterm delivery. While most women do not receive preconceptional care, restricting weight gain to the within the recommended range can reduce the risk of postterm pregnancy in normal, overweight, and obese women.

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Maternal obesity is a potential source of error in mid‐trimester ultrasound estimation of gestational age

Abstract: ObjectivesTo investigate the possible impact of maternal obesity on ultrasonographic dating of pregnancy. (OR, 1.65; 95% CI, 1.45; 95% CI, Methods

Cited by 33 publications

References 22 publications

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

United States Birth Weight Reference Corrected For Implausible Gestational Age Estimates

Effect of maternal weight on postterm delivery

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