Midtrimester Isolated Short Femur Length as a Predictor of Adverse Pregnancy Outcome

Abstract

Objective: The aim of this study was to investigate whether midtrimester isolated short femur length is associated with pregnancy complications. Study Design: Retrospective analysis of pregnancies with a midtrimester femur length <5th percentile for gestational age compared to controls with a femur length ≥5th percentile. Outcome measures included hypertensive disorders, being small for gestational age, oligohydramnios and preterm delivery. Results: 2,105 women were eligible for this study, 85 (3.45%) of whom were in the study group and 2,020 were controls. Birth weight <10th percentile for gestational age (OR 4.4, 95% CI 2.5-7.8), birth weight <3rd percentile for gestational age (OR 31.0, 95% CI 13.3-72.3) and severe preeclampsia (OR 6.3, 95% CI 1.4-28.6) were significantly associated with midtrimester isolated short femur length. Conclusions: Midtrimester isolated short femur length is associated with higher rates of being small for gestational age and preeclampsia.

Midtrimester isolated short femur and perinatal outcomes: A systematic review and meta‐analysis

“…The present meta-analysis shows that an isolated short femur increases IUGR or SGA risk fourfold in contrast with fetuses with a normal femur biometry. 1,8,9,[19][20][21] In this regard, in our study we found an increased risk for preterm birth, fetal demise, low birthweight, Apgar <7 at It should be underlined that in the case of isolated short femur, conservative counseling should be given to prospective parents because an uncomplicated pregnancy with a normal neonate at term has been reported in 61% of cases. These data support the hypothesis that an isolated short FL might be considered an early marker for placental dysfunction.…”

“…In addition, a higher incidence of perinatal complication was found in fetuses with isolated short femur length: Low birthweight (study group: (Figure 9). 8,9,[19][20][21][22] In particular, we found an overall prevalence of IUGR or SGA of 14.2% in the short femur group, compared with 5.2% in the general population with an OR of 4.04 (95% CI 3.63-4.50). The present meta-analysis shows that an isolated short femur increases IUGR or SGA risk fourfold in contrast with fetuses with a normal femur biometry.…”

“…The results showed low heterogeneity (0%) 8,9,[19][20][21][22] (Figure 2). In addition, a higher incidence of perinatal complication was found in fetuses with isolated short femur length: Low birthweight (study group: (Figure 9).…”

“…A value of 0% indicates no observed heterogeneity, whereas I 2 values ≥50% indicate a substantial level of heterogeneity. 8,9,[19][20][21][22] The results of the quality assessment of the included studies using NOS are presented in Table 1. 16 Publication bias was examined using analyses described by Egger et al 17 Table S1.…”

“…IUGR was considered birthweight below the 10th percentile for gestational age 20 estimated fetal weight or abdominal circumference below the 5th percentile at the midtrimester anomaly scan 8 or abdominal circumference below the 10th percentile 19. …”