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Badr DA, Cannie MM, Kadji C, Kang X, Carlin A, Jani JC. Performance of fetal ultrasound and magnetic resonance imaging in predicting birthweight according to the test-to-delivery interval: A cohort study. Eur J Obstet Gynecol Reprod Biol 2024; 292:138-146. [PMID: 38006818 DOI: 10.1016/j.ejogrb.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/08/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To assess the influence of the test-to-delivery interval (TDI) on the performance of ultrasound (US) and magnetic resonance imaging (MRI) for predicting birthweight (BW). STUDY DESIGN This is a secondary analysis of a prospective, single center, blinded cohort study that compared MRI and US for the prediction of BW ≥ 95th percentile in singleton pregnancies. Patients that were included in the initial study underwent US and MRI for estimation of fetal weight between 36 + 0/7 and 36 + 6/7 weeks of gestation (WG). The primary outcome of the current study was to report the changes of US and MRI sensitivity and specificity in the prediction of BW > 95th percentile, BW > 90th percentile, BW < 10th percentile, and BW < 5th percentile, according to the TDI. The secondary outcome was to represent the performance of both tools in the prediction of BW > 90th percentile when TDI is<2 weeks, between 2 and 4 weeks, and>4 weeks. Receiver operating characteristic (ROC) curves were constructed accordingly. RESULTS 2378 patients were eligible for final analysis. For the prediction of BW > 95th or 90th percentile, the sensitivity of MRI remains high until 2 weeks, and it decreases slowly between 2 and 4 weeks, in contrast to the sensitivity of US which decreases rapidly 2 weeks after examination (p < 0.001). For the prediction of BW < 10th or 5th percentile, the sensitivity of both tools decreases in parallel between 1 and 2 weeks. The specificities of both tools remain high from examination till delivery. These findings are reproducible with the use of the antenatal customized and the postnatal national growth charts. CONCLUSION The performance of MRI in the prediction of BW, especially in large-for-gestational age, is maximal when delivery occurs within two weeks of the examination, decreasing slightly thereafter, in contrast with the performance of US which decreases drastically over time.
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Affiliation(s)
- Dominique A Badr
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Mieke M Cannie
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium; Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Caroline Kadji
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Xin Kang
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Andrew Carlin
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Jacques C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
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Hans N, Klein N, Faschingbauer F, Schneider M, Mayr A. Boosting distributional copula regression. Biometrics 2023; 79:2298-2310. [PMID: 36165288 DOI: 10.1111/biom.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
Capturing complex dependence structures between outcome variables (e.g., study endpoints) is of high relevance in contemporary biomedical data problems and medical research. Distributional copula regression provides a flexible tool to model the joint distribution of multiple outcome variables by disentangling the marginal response distributions and their dependence structure. In a regression setup, each parameter of the copula model, that is, the marginal distribution parameters and the copula dependence parameters, can be related to covariates via structured additive predictors. We propose a framework to fit distributional copula regression via model-based boosting, which is a modern estimation technique that incorporates useful features like an intrinsic variable selection mechanism, parameter shrinkage and the capability to fit regression models in high-dimensional data setting, that is, situations with more covariates than observations. Thus, model-based boosting does not only complement existing Bayesian and maximum-likelihood based estimation frameworks for this model class but rather enables unique intrinsic mechanisms that can be helpful in many applied problems. The performance of our boosting algorithm for copula regression models with continuous margins is evaluated in simulation studies that cover low- and high-dimensional data settings and situations with and without dependence between the responses. Moreover, distributional copula boosting is used to jointly analyze and predict the length and the weight of newborns conditional on sonographic measurements of the fetus before delivery together with other clinical variables.
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Affiliation(s)
- Nicolai Hans
- Chair of Statistics and Data Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nadja Klein
- Chair of Statistics and Data Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Faschingbauer
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Michael Schneider
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Andreas Mayr
- Department of Medical Biometrics, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
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Pretscher J, Kehl S, Stelzl P, Stumpfe FM, Mayr A, Schmid M, Staerk C, Schild R, Beckmann MW, Faschingbauer F. Influence of Sonographic Fetal Weight Estimation Inaccuracies in Macrosomia on Perinatal Outcome. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:e56-e64. [PMID: 32767300 DOI: 10.1055/a-1205-0191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the influence of inaccurate sonographic fetal weight estimation in macrosomia on the mode of delivery and neonatal outcome (NO). METHODS In 14 633 pregnancies between 2002 and 2016, this retrospective study evaluated the association between sonographic fetal weight estimation, true birth weight (BW), mode of delivery (primary cesarean section [pCS], secondary cesarean section, vaginal delivery, and operative vaginal delivery rates) and NO parameters (5-min Apgar < 7, pH < 7.1, neonatal intensive care unit [NICU] admission, shoulder dystocia). Singleton pregnancies > 37 + 0 weeks with ultrasound-estimated fetal weight (EFW) within 7 days before delivery were included. The study population was divided into four groups: Group 1 (false-negative): EFW < 4000 g/BW ≥ 4000 g; Group 2 (true-positive): EFW ≥ 4000 g/BW ≥ 4000 g; Group 3 (false-positive): EFW ≥ 4000 g/BW < 4000 g; and Group 4 (true-negative): EFW < 4000 g/BW < 4000 g. RESULTS As expected, the highest secondary cesarean section (sCS) rate was found in Group 2 (true-positive) (30.62 %), compared with only 17.68 % in Group 4 (true-negative). The sCS rate in the false-positive Group 3 was significantly higher (28.48 %) in comparison with the false-negative Group 1 (21.22 %; OR 1.48; 95 % CI, 1.16 to 1.89; P = 0.002). In comparison with the true-negative Group 4, univariate analyses showed significantly higher rates for sCS in all other groups: odds ratio (OR) 2.06 for Group 2 (95 % CI, 1.74 to 2.42; P < 0.001), 1.85 for Group 3 (95 % CI, 1.54 to 2.22, P < 0.001), and 1.25 for Group 1 (95 % CI, 1.05 to 1.49; P < 0.01). No significant differences were found for NO between Groups 1 and 3 for the parameters 5-min Apgar < 7 (P = 0.75), pH < 7.1 (P = 0.28), or NICU admission (P = 0.54). However, there was a significantly higher chance for shoulder dystocia in Group 1 compared with Group 3 (OR 4.58; 95 % CI, 1.34 to 24.30; P = 0.008). CONCLUSION Sonographic EFW inaccuracies in fetal macrosomia appear to have a greater impact on the mode of delivery than birth weight itself. Underestimation of fetal weight may be associated with a higher probability of shoulder dystocia.
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Affiliation(s)
- Jutta Pretscher
- Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sven Kehl
- Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Patrick Stelzl
- Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Andreas Mayr
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Germany
| | - Christian Staerk
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Germany
| | - Ralf Schild
- Obstetrics and Gynecology, DIAKOVERE gGmbH, Hannover, Germany
| | - Matthias W Beckmann
- Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Florian Faschingbauer
- Obstetrics and Gynecology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Bicocca MJ, Le TN, Zhang CC, Blackburn B, Blackwell SC, Sibai BM, Chauhan SP. Identification of newborns with birthweight ≥ 4,500g: Ultrasound within one- vs. two weeks of delivery. Eur J Obstet Gynecol Reprod Biol 2020; 249:47-53. [PMID: 32353616 DOI: 10.1016/j.ejogrb.2020.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Our objective was to compare the diagnostic characteristics of sonographic estimated fetal weight (SEFW) done within 7 versus 8-14 days before delivery for detection of fetal macrosomia (birthweight ≥ 4500 g). STUDY DESIGN We performed a multicenter, retrospective cohort study of all non-anomalous singletons with SEFW ≥ 4000 g by Registered Diagnostic Medical Sonographers conducted within 14 days of delivery. Cohorts were grouped by time interval between ultrasound and delivery: 0-7 days versus 8-14 days. The detection rate (DR) and false positive rate (FPR) for detection of birthweight (BW) ≥ 4500 g were compared between groups with subgroup analysis for diabetic women. Area under the receiver operator curve (AUC) was calculated to analyze all possible SEFW cutoffs within our cohort. RESULTS A total of 330 patients met inclusion criteria with 250 (75.8 %) having SEFW within 7 days and 80 (24.2 %) with SEFW 8-14 days prior to delivery. The rate of macrosomia was 15.1 % (N = 51). The DR for macrosomia was significantly higher when SEFW was performed within 7 days of delivery compared to 8-14 days among non-diabetic (73.0 % vs 7.1 %; p < 0.001) and diabetic women (76.5 % vs 16.7 %; p = 0.02). There was no significant change in FPR in either group. The AUC for detection of macrosomia was significantly higher when SEFW was performed within 7 days versus 8-14 days (0.89 vs 0.63; p < 0.01). CONCLUSION With SEFW ≥ 4000 g, the detection of BW ≥ 4500 g is significantly higher when the sonographic examination is within 7 days of birth irrespective of maternal diabetes.
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Affiliation(s)
- Matthew J Bicocca
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - Tran N Le
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Caroline C Zhang
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Bonnie Blackburn
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, United States
| | - Sean C Blackwell
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Baha M Sibai
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Pretscher J, Kehl S, Stumpfe FM, Mayr A, Schmid M, Schild RL, Beckmann MW, Faschingbauer F. Ultrasound Fetal Weight Estimation in Diabetic Pregnancies. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:341-350. [PMID: 31436342 DOI: 10.1002/jum.15112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/14/2019] [Accepted: 06/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate different formulas for estimating fetal weight in diabetic pregnancies. METHODS This retrospective study evaluated the precision of ultrasound fetal weight estimation in 756 pregnancies complicated by gestational diabetes between 2002 and 2016. The estimated fetal weights (EFWs) were obtained within 7 days of delivery from 10 weight estimation formulas and were compared with pair-wise matched controls from 15,701 patients. The precision of the evaluated formulas for EFW was analyzed by median absolute percentage errors (MAPEs), mean percentage errors (MPEs), and proportions of estimates within 10% of actual birth weight. RESULTS Among the tested formulas, the lowest MAPE was detected with formula I of Hadlock et al (Am J Obstet Gynecol 1985; 151:333-337), and the formula of Schild et al (Ultrasound Obstet Gynecol 2004; 23:30-35) had the highest proportion of estimates within the 10% range. The EFW in diabetic patients showed a slight trend toward overestimation in comparison with the matched controls (MPE estimates showed a trend toward more positive values). In most of the EFW formulas that were evaluated, no significant differences were detected in MAPEs and estimates within the 10% range. The MPE estimates with most formulas in both groups were close to zero. Overall, the differences between most of the evaluated formulas were small. CONCLUSIONS Little evidence was found for differences in the accuracy of the EFW in diabetic pregnancies and controls. The Hadlock I formula showed the lowest MAPE, and the Schild formula had the highest proportion of estimates within the 10% range.
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Affiliation(s)
- Jutta Pretscher
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany
| | - Sven Kehl
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany
| | - Florian M Stumpfe
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany
| | - Andreas Mayr
- Department of Medical Biometry, Informatics, and Epidemiology, Bonn University Hospital, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics, and Epidemiology, Bonn University Hospital, Bonn, Germany
| | - Ralf L Schild
- Department of Obstetrics and Perinatal Medicine, Perinatalzentrum Hannover, Diakovere Krankenhaus gGmbH, Hannover, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany
| | - Florian Faschingbauer
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany
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Does the Porter formula hold its promise? A weight estimation formula for macrosomic fetuses put to the test. Arch Gynecol Obstet 2019; 301:129-135. [PMID: 31883045 PMCID: PMC7028832 DOI: 10.1007/s00404-019-05410-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 12/07/2019] [Indexed: 11/06/2022]
Abstract
Purpose Estimating fetal weight using ultrasound measurements is an essential task in obstetrics departments. Most of the commonly used weight estimation formulas underestimate fetal weight when the actual birthweight exceeds 4000 g. Porter et al. published a specially designed formula in an attempt to improve detection rates for such macrosomic infants. In this study, we question the usefulness of the Porter formula in clinical practice and draw attention to some critical issues concerning the derivation of specialized formulas of this type. Methods A retrospective cohort study was carried out, including 4654 singleton pregnancies with a birthweight ≥ 3500 g, with ultrasound examinations performed within 14 days before delivery. Fetal weight estimations derived using the Porter and Hadlock formulas were compared. Results Of the macrosomic infants, 27.08% were identified by the Hadlock formula, with a false-positive rate of 4.60%. All macrosomic fetuses were detected using the Porter formula, with a false-positive rate of 100%; 99.96% of all weight estimations using the Porter formula fell within a range of 4300 g ± 10%. The Porter formula only provides macrosomic estimates. Conclusions The Porter formula does not succeed in distinguishing macrosomic from normal-weight fetuses. High-risk fetuses with a birthweight ≥ 4500 g in particular are not detected more precisely than with the Hadlock formula. For these reasons, we believe that the Porter formula should not be used in clinical practice. Newly derived weight estimation formulas for macrosomic fetuses must not be based solely on a macrosomic data set. Electronic supplementary material The online version of this article (10.1007/s00404-019-05410-7) contains supplementary material, which is available to authorized users.
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Liao K, Tang L, Peng C, Chen L, Chen R, Huang L, Liu P, Chen C. Two new models for the estimation of foetal weight more than a week before delivery: An MRI study. Eur J Radiol 2019; 121:108596. [PMID: 31623899 DOI: 10.1016/j.ejrad.2019.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To develop and evaluate new formulas to determine the magnetic resonance imaging (MRI)-based estimated foetal weight (EFW) more than a week before delivery. METHODS The study included 153 women with singleton pregnancies who gave birth to live, normal neonates within 15-21 days of the MRI examination for whom foetal body volume biometry data were available at term. All foetuses were randomly divided into a testing group (102) and a validation group (51). Regression analysis was used to determine the single volume or the combination of volume and MRI-to-delivery interval that determined the EFW. The accuracy of the two new models and the primary existing model developed by Baker et al. were evaluated in validation group. RESULTS The two new models had similar mean percentage errors (MPEs) (3.9% vs 3.9%) and proportions of pregnancies with an MPE < 10% (92.2% vs 90.2%); the model incorporating volume and MRI-to-delivery had relatively higher proportions of pregnancies with an MPE < 5% (72.5% vs 64.7%) and EFWs in agreement with the birth weights. The error in the Baker model was almost twice that in the new models. CONCLUSION The accuracy of foetal weight estimation more than one week before delivery using the model developed by Baker et al. was poor and was significantly improved by the new models. A combination of the foetal body volume and MRI-to-delivery interval will enable the more accurate determination of the EFWs.
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Affiliation(s)
- Kedan Liao
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Lian Tang
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Cheng Peng
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Lan Chen
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Ruiying Chen
- Department of Radiology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Lu Huang
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Ping Liu
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China.
| | - Chunlin Chen
- Department of Obstetrics and Gynaecology, NanFang Hospital, Southern Medical University, Guangzhou, China.
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Comparison of the accuracy of INTERGROWTH-21 formula with other ultrasound formulae in fetal weight estimation. Taiwan J Obstet Gynecol 2019; 58:273-277. [PMID: 30910152 DOI: 10.1016/j.tjog.2019.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE A new ultrasound formula for fetal weight estimation was proposed from the INTERGROWTH-21 project in 2017. There is no comparison of its accuracy with other ultrasound formulae. This study aims to compare the accuracy of INTERGROWTH-21 formula in fetal weight estimation with the traditional Hadlock1 and Shepard formula. MATERIALS AND METHODS All pregnant patients who had delivery in United Christian Hospital between January to December 2016 were retrospectively reviewed. Those who had prenatal ultrasound scan performed within 7 days of delivery were recruited. Hadlock1, Shepard and INTERGROWTH-21 formula were used to estimate the fetal weight and their accuracies were compared with the actual birthweight of neonates. RESULTS A total of 403 patients were recruited. Hadlock1 was the most accurate with the lowest mean absolute percentage error (MAPE) 7.34 when compared with Shepard (9.00; p < 0.001) and INTERGROWTH-21 (9.07; p < 0.001). INTERGROWTH-21 had the lowest proportion of patients having estimated fetal weight within 10% discrepancy from the actual birthweight (57.6%) compared with Hadlock1 (71.2%; p < 0.001) and Shepard (66.3; p = 0.011). Presence of intrauterine growth restriction (IUGR) or fetal macrosomia (>=4000 g) were both associated with significantly higher MAPE in Hadlock1 and INTERGROWTH-21. IUGR (p = 0.005) and macrosomia (p = 0.004) remained significant in the final equation of logistic regression model that affect the precision of fetal weight estimation in Hadlock1, while only IUGR was significant in INTERGROWTH-21 (p < 0.001). CONCLUSION INTERGROWTH-21 formula was not shown to be better than the traditional Hadlock1 or Shepard formulae. Future prospective studies would be required to evaluate the accuracy of INTERGROWTH-21 formula especially at the extremes of birthweight.
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Bo C, Jie Y, E G, Chuan F, Long Z. A method for estimating fetal weight based on body composition. J Matern Fetal Neonatal Med 2018; 32:3306-3314. [DOI: 10.1080/14767058.2018.1459555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Chen Bo
- School of Information Engineering, Dalian University, Dalian, China
| | - Yu Jie
- School of Information Engineering, Dalian University, Dalian, China
| | - GaoXiu E
- School of Information Engineering, Dalian University, Dalian, China
| | - FanGui Chuan
- School of Information Engineering, Dalian University, Dalian, China
| | - ZhangWen Long
- School of Information Engineering, Dalian University, Dalian, China
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Elessawy M, Harders C, Kleinwechter H, Demandt N, Sheasha GA, Maass N, Pecks U, Eckmann-Scholz C. Measurement and evaluation of fetal fat layer in the prediction of fetal macrosomia in pregnancies complicated by gestational diabetes. Arch Gynecol Obstet 2017. [PMID: 28631075 DOI: 10.1007/s00404-017-4433-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore the predictive power of measuring the abdominal fetal fat layer (FFL) as a soft tissue marker at 31, 34, and 37 weeks' gestation to improve the detection of fetal macrosomia in pregnant women with GDM, in addition to the biometric values with close monitoring of maternal blood sugar level and BMI changes. METHODS We conducted a prospective observational study at the Department of Obstetrics, University Hospitals, Campus Kiel, Germany, in collaboration with diabetic clinic staff. Participants underwent a third-trimester scan and extra FFL measurements were performed at 31, 34, and 37 weeks of gestation. The clinical outcomes of pregnancy and birth weight were collected from the obstetric record. All of the enrolled women had an early pregnancy ultrasound scan to confirm gestational age. RESULTS The FFL at 34 and 37 weeks, with respective cutoff values of >0.48 cm and >0.59 cm, showed a very good sensitivity of 60% for both gestational points, and specificity of 89.3 and 90.6%, respectively. The probability of fetal macrosomia could be more than doubled if the FFL at 34 weeks was more than 0.48 cm. However, the probability of macrosomia dropped to 16% if the FFL was ≤0.48 cm. The median FFLs of macrosomic fetuses at 34 and 37 weeks were 0.50 (IQR 0.10) and 0.60 (IQR 0.25) cm, respectively. The mean age of the study population (n = 80) was 32.26 (SD = 5.06) years. In our study population, ten newborns were born with birth weight >4000 g. The body mass index (BMI) for the mothers of later-onset macrosomic newborns showed higher median values of 30 (IQR 8), 32 (IQR 5), and 33 (IQR 9) at 31, 34, and 37 weeks, respectively, in comparison to mothers of non-macrosomic newborn. However, the BMI did not show any statistically significant difference from those with normal-weight newborn and did not show any specific sensitivity for predicting macrosomia. CONCLUSION Measuring the FFL at 34 and 37 weeks of gestation, in addition to the standard measurement, might be useful for predicting macrosomia and is worth further evaluation.
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Affiliation(s)
- Mohamed Elessawy
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany.
| | - Christina Harders
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany
| | | | | | - Ghada Abu Sheasha
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Nicolai Maass
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany
| | - Ulrich Pecks
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany
| | - Christel Eckmann-Scholz
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany
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REN FENG, HU YU, ZHOU HUAN, ZHU WENYING, JIA LI, XU JINGJING, XUE JING. Second trimester maternal serum triple screening marker levels in normal twin and singleton pregnancies. Biomed Rep 2016; 4:475-478. [DOI: 10.3892/br.2016.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/11/2016] [Indexed: 11/06/2022] Open
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Accuracy of sonographic fetal weight estimation: influence of the scan-to-delivery interval in combination with the applied weight estimation formula. Arch Gynecol Obstet 2016; 294:487-93. [DOI: 10.1007/s00404-015-3989-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 12/10/2015] [Indexed: 10/22/2022]
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