Predictive value of conditional centile charts for weight and fundal height in pregnancy in detecting light for gestational age births

Thompson, Mary Lou; Theron, Gerhard; Fatti, L.P.

doi:10.1016/s0301-2115(96)02643-7

Cited by 20 publications

(15 citation statements)

References 18 publications

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“…Some authors use also the new term FGR with reference to birth length [11,12]. Moreover, the same terms SGA, IUGR and now FGR are used either for diagnosing at birth or for screening during fetal life from sonographic measurements [13].…”

Section: Introductionmentioning

confidence: 99%

“…In a recent review of the literature, we listed various solutions found for adjusting birth weight limits to maternal characteristics [15]. The classical method consisted of dividing the population into subgroups according to fetal or maternal characteristics, such as sex [1,11,[16][17][18][19][20][21][22][23][24][25][26], sex and parity [1,11,19], or race [1,17,19,26]. Based on a large sample, Thomson et al [11] gave a difference of more than 200 g between a girl born from a primiparous mother to a boy born from a multiparous one.…”

Section: Introductionmentioning

confidence: 99%

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Definition of Fetal Growth Restriction According to Constitutional Growth Potential

2001

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Identification of newborn babies with fetal growth restriction remains a problem both from the multi-factorial aspect of fetal growth and from statistical definition. Besides the usual terms: ‘Small for gestational age’ (SGA) and intrauterine growth retardation (IUGR), often used synonymously, the term ‘fetal growth retardation’ was recently introduced in reference to the genetic growth potential of infants. From a sample of 72,000 births, we have designed a statistical model in order to estimate the expected birth weight taking into account gestational age, sex, birth rank, maternal age, height and pregravid weight, we then calculated an individual limit of birth weight under that a newborn must be considered as having a ‘fetal growth restriction’ quoted FwGR. This new approach allowed us to identify 2 groups of newborns with FGR, one classically identified as SGA (noted FwGR_I) (3.9%), and the other newly identified as FGR (noted FwGR_II) (1.4%). In contrast, this approach allowed us to identify a group of ‘constitutionally small’ infants according to their constitutional growth potential (1.1%). In other words, among infants usually defined as SGA (5%), 22% appeared in fact to be ‘constitutionally small’ and therefore misclassified. As an initial validation, we observed that the proportion of maternal hypertension during pregnancy was low in the ‘constitutionally small’ infants (close to that of the normal group), and three times higher in the newly identified group FwGR_II than in the normal group. Following these results, it seems to be meaningful to follow-up this new group of FwGR_II infants, in terms of catch-up growth and neurodevelopmental outcome.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Definition of Fetal Growth Restriction According to Constitutional Growth Potential

2001

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“…29,30 The most common critique is that cut-offs are based on highest and lowest 5 or 10 percentiles and not on the risk of morbidity. 29,30 However, such an approach would still be possible to criticise for arbitrariness, since the choice of outcome measure is not obvious. Previous researchers have used dyslipoproteinemia and blood pressure when creating cutoffs for excess weight for children.…”

Section: Discussionmentioning

confidence: 99%

Identification of women at risk of adverse weight development following pregnancy

Linné

Neovius

2006

Int J Obes

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Background: It has been known for long time that pregnancy associated with weight problems women but few important factors have been identified, except for weight gain during pregnancy itself. Objective: To identify cutoffs for weight gain during pregnancy for identification of women at risk of high weight retention after pregnancy. Methods: A longitudinal analysis of 563 women who gave birth in 1984-1985 was used. Weight development during pregnancy was used as diagnostic test for high weight retention at 1 and 15 years follow-up. True positives for high weight retention were defined as 490th percentile at 1 and 15 years. Receiver Operating Characteristic (ROC) analyses were performed to derive cutoffs minimizing the absolute and relative number of misclassifications. Results: The average weight retention at 1 year (WR 1y ) and 15 years (WR 15y ) was 1.173.6 and 7.677.4, respectively. There was a moderately strong correlation between weight gain during pregnancy and weight retention at 1 and 15 years follow-up (r 2 ¼ 0.13 and r 2 ¼ 0.05, respectively; both Po0.001) and weight gain during pregnancy as diagnostic test to find high weight retainers performed better than chance both for WR 1y (AUC ¼ 0.7670.04, Po0.01) and WR 15y (0.6370.04, Po0.05). To minimize the absolute number of misclassifications of high weight retention, a highly specific and insensitive cut-off of around 24 kg weight gain during pregnancy was needed. The best trade-off between sensitivity and specifity, minimizing the relative number of misclassifications, was at a cutoff of around 16 kg, but this resulted in three times as many absolute misclassifications. Conclusion: Weight gain during pregnancy was found to be a moderately strong diagnostic test for weight retention after pregnancy. In order to implement weight gain recommendations for clinical practice larger studies need to be conducted and the demands on the reference values specified, since decisions about the trade-offs between types and extent of misclassifications need to be made.

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“…All women with a fundal height (FH) of 24 cm maximum were offered a fetal anomaly scan at an estimated GA of 18-23 weeks. In addition, ultrasound examinations were offered for the following predefined clinical indications: FH greater than the 90th percentile or less than the 10th percentile (P10) [12]; clinical suspicion of twins; malpresentation at 36 weeks or more; post-term pregnancy; and low-lying placenta on a previous scan. After the target number for the cohort was reached (n = 750), the scanning protocol was changed.…”

Section: Methodsmentioning

confidence: 99%

The value of adding a universal booking scan to an existing protocol of routine mid‐gestation ultrasound scan

Poggenpoel

Geerts

Theron

2011

Intl J Gynecology & Obste

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Predictive value of conditional centile charts for weight and fundal height in pregnancy in detecting light for gestational age births

Cited by 20 publications

References 18 publications

Definition of Fetal Growth Restriction According to Constitutional Growth Potential

Definition of Fetal Growth Restriction According to Constitutional Growth Potential

Identification of women at risk of adverse weight development following pregnancy

The value of adding a universal booking scan to an existing protocol of routine mid‐gestation ultrasound scan

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