Sonographic prediction of macrosomia cannot be improved by combination with pregnancy‐specific characteristics

Balsyte, Dalia; Schäffer, Leonhard; Burkhardt, Tilo; Wisser, J.; Kurmanavičius, Juozas

doi:10.1002/uog.6282

Cited by 29 publications

(25 citation statements)

References 26 publications

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“…Nahum and Stanislaw [54] and similarly Mazouni et al [55] combined sonographic data with maternal and pregnancy-specific variables such as gestational age, parity, fetal sex, maternal height and weight to increase the detection rate of macrosomic fetuses. Both studies showed some improvement but in a recent independent study these results were not confirmed [56] .…”

Section: Discussionmentioning

confidence: 64%

Performance of 36 Different Weight Estimation Formulae in Fetuses with Macrosomia

et al. 2010

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Introduction: The aim of this retrospective clinical study was to compare the accuracy of 36 commonly used weight estimation formulae in macrosomic fetuses. Material and Methods: Ultrasound estimation of fetal weight (FW) was carried out within 7 days up to delivery in 350 singleton fetuses with a birth weight (BW) of ≧4,000 g. The accuracy of the different formulae for FW estimation was compared by, firstly, the mean percentage (MPE) and mean absolute percentage error (MAPE), secondly, by the frequency distribution of differences between estimated FW and fetal BW, and thirdly by comparing detection and false positive rates in screening for fetuses with a BW of 4,000, 4,300 and 4,500 g or more. Results: MPE ranged from –62.2 to 9.6% and was closest to 0 with the Hart formula. With 12 of 36 weight estimation formulae, MAPE was 10% or less, and was smallest with the Hart formulae (3.9%). The mean detection rate among all formulae for fetuses with a BW ≧4,000, ≧4,300 and ≧4,500 g was 29, 24 and 22%, respectively, and the false positive rate was 12% (for ≧4,300 g) and 7% (≧4,500 g). Discussion: Some formulae showed advantages as far as mean and absolute percentage errors were concerned, but none reached a detection rate and false positive rate for fetuses ≧4,500 g that could lead to clinical recommendation.

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Section: Discussionmentioning

confidence: 64%

Performance of 36 Different Weight Estimation Formulae in Fetuses with Macrosomia

et al. 2010

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“…Another option, especially for heavier infants, is an optimisation of the weight estimation through a combination of ultrasound findings with maternal and pregnancy-specific parameters such as gestational age, parity, gender of the foetus, and maternal height or weight. The presumed benefit of such an elaborate procedure is, however, a subject of controversial discussion in the current literature [45][46][47]. Nevertheless, there is consensus that maternal obesity increases the estimation errors [48,49].…”

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confidence: 99%

Comparison of Errors of 35 Weight Estimation Formulae in a Standard Collective

Hoopmann

Kagan

Sauter

et al. 2016

Geburtshilfe Frauenheilkd

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The estimation of foetal weight is an integral part of prenatal care and obstetric routine. In spite of its known susceptibility to errors in cases of underweight or overweight babies, important obstetric decisions depend on it. In the present contribution we have examined the accuracy and error distribution of 35 weight estimation formulae within the normal weight range of 2500-4000 g. The aim of the study was to identify the weight estimation formulae with the best possible correspondence to the requirements of clinical routine. Materials and Methods: 35 clinically established weight estimation formulae were analysed in 3416 foetuses with weights between 2500 and 4000 g. For this we determined and compared the mean percentage error (MPE), the mean absolute percentage error (MAPE), and the proportions of estimates within the error ranges of 5, 10, 20 and 30%. In addition, separate regression lines were calculated for the relationship between estimated and actual birth weights for the weight range 2500-4000 g. The formulae were thus examined for possible inhomogeneities. Results: The lowest MPE were achieved with the Hadlock III and V formulae (0.8%, STW 9.2 % or, respectively, −0.8 %, STW 10.0 %). The lowest absolute error (6.6 %) as well as the most favourable frequency distribution in cases below 5 % and 10 % error (43.9 and 77.5) were seen for the Halaska formula. In graphic representations of the regression lines, 16 formulae revealed a weight overestimation in the lower weight range and an underestimation in the upper range. 14 formulae gave underestimations and merely 5 gave overestimations over the entire tested weight range. Conclusion: The majority of the tested formulae gave underestimations of the actual birth weight over the entire weight range or at least in the upper weight range. This result supports the cur-

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“…Despite the poor performance of weight estimation formulas in macrosomic fetuses in general [13, 25], estimating fetal weight is an essential part of everyday routine work in an obstetric department in the effort to detect infants who are at risk. Suspected macrosomia always alters the approach to a pregnancy in relation to possible perinatal risks and unwanted effects [26].…”

Section: Discussionmentioning

confidence: 99%

Disadvantages of a weight estimation formula for macrosomic fetuses: the Hart formula from a clinical perspective

Weiss¹,

Oppelt²,

Mayer³

2018

Arch Gynecol Obstet

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PurposeSonographic fetal weight (FW) estimation to detect macrosomic fetuses is an essential part of everyday routine work in obstetrics departments. Most of the commonly used weight estimation formulas underestimate FW when the actual birth weight (BW) exceeds 4000 g. One of the best-established weight estimation formulas is the Hadlock formula. In an effort to improve the detection rates of macrosomic infants, Hart et al. published a specially designed formula including maternal weight at booking. The usefulness of the Hart formula was tested.MethodsRetrospective study of 3304 singleton pregnancies, birth weight ≥ 3500 g. The accuracy of the Hadlock and Hart formula were tested. A subgroup analysis examined the influence of the maternal weight. The Chi-squared test and one-way analysis of variation were carried out. For all analyses, p < 0.05 was considered statistically significant.ResultsThe overall percentages of births falling within ± 5% and ± 10% of the BW using the Hadlock formula were 27% and 53%, respectively. Using the Hart formula, 24% and 54% were identified within these levels. With the Hart formula, 94% of all weight estimations fall within 4200 g ± 5% and nearly 100% fall within 4200 g ± 10%.ConclusionsApplying the Hart formula results in an overestimation of fetal weight in neonates with a birth weight < 4000 g and fails to identify high-risk fetuses. We, therefore, do not consider Hart’s formula to be of clinical relevance.

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Sonographic prediction of macrosomia cannot be improved by combination with pregnancy‐specific characteristics

Abstract: respectively; P < 0.0005), whereas the performance of the Nahum and Stanislaw equation was similar but not superior to ultrasound alone (AUC 0.895, respectively; P > 0.05

Cited by 29 publications

References 26 publications

Performance of 36 Different Weight Estimation Formulae in Fetuses with Macrosomia

Performance of 36 Different Weight Estimation Formulae in Fetuses with Macrosomia

Comparison of Errors of 35 Weight Estimation Formulae in a Standard Collective

Disadvantages of a weight estimation formula for macrosomic fetuses: the Hart formula from a clinical perspective

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