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Gevaerd Martins J, Kawakita T, Jain P, Gurganus M, Baraki D, Barake C, Sinkovskaya E, Abuhamad A. Impact of maternal body mass index on the accuracy of third trimester sonographic estimation of fetal weight. Arch Gynecol Obstet 2023; 307:395-400. [PMID: 35332361 DOI: 10.1007/s00404-022-06495-3] [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: 02/03/2022] [Accepted: 02/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To Determine whether maternal body mass index (BMI) can affect the accuracy of sonographic estimation of fetal weight (EFW) in the third trimester when compared to neonatal birthweight (BW). METHODS Secondary analysis from our original prospective cohort of pregnant women beyond 34 weeks, distributed in 4 groups according to their BMI: normal, overweight, obese and morbid obese. Fetal biometry and fluid measurements were obtained by two experienced sonographers, blinded for patient's clinical information and to each other's measurements. Average EFW and neonatal BW were converted into gestational-specific Z-scores. Interobserver correlation coefficient (ICC) and Cronbach's reliability coefficient (CRC) were calculated. Bland-Altman (BA) plots were constructed to assess the level of accuracy. RESULTS 100 women were enrolled (800 measurements obtained by 17 sonographers): 17 had normal BMI (17%), 27 were overweight (27%), 29 were obese (29%) and 27 were morbidly obese (27%). There was no statistical difference for GA at delivery (p = 0.74), EFW (p = 0.05) or BW (p = 0.09) between groups (Table 1). Mean Z-score for EFW was - 0.17 (SD 0.81) and for neonatal BW was - 0.25 (SD 0.74). ICC was 0.69 (95% CI 0.57, 0.78) and CRC was 0.82. Mean Z-score difference was small (Table 2). When stratifying according to BMI categories, the ICC ranged from 0.49 to 0.76. Reliability indices ranged from 0.66 to 0.86. The Z-scores' differences were overall small with no statistical difference (Table 3). BA showed evenly distributed interobserver differences (Fig. 1). CONCLUSIONS When performed by trained sonographers, fetal weight estimation in the third trimester is accurate when compared to neonatal birthweight at increasing BMI categories.
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Affiliation(s)
- Juliana Gevaerd Martins
- EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA.
| | - Tetsuya Kawakita
- EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA
| | - Priyanka Jain
- University of Virginia Maternal Fetal Medicine Fellow (PGY-5), Charlottesville, USA
| | - Margot Gurganus
- University of Virginia OBGYN Resident (PGY-3), Charlottesville, USA
| | - Dana Baraki
- EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA
| | | | - Elena Sinkovskaya
- EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA
| | - Alfred Abuhamad
- EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA
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Zhu L, Zhou B, Zhu X, Cheng F, Pan Y, Zhou Y, Wu Y, Xu Q. Association Between Body Mass Index and Female Infertility in the United States: Data from National Health and Nutrition Examination Survey 2013–2018. Int J Gen Med 2022; 15:1821-1831. [PMID: 35221716 PMCID: PMC8865871 DOI: 10.2147/ijgm.s349874] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/09/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose This study aimed to investigate the effects of body mass index (BMI) on infertility in women of childbearing age. Patients and Methods We performed a cross-sectional study using data from 3624 participants from the National Health and Nutrition Examination Survey (NHANES). We used BMI and fertility status in the survey as independent and dependent variables, respectively. We evaluated their relationship and used smoothed curve fitting and multivariate logistic regression analysis as well as a generalized additive model (GAM) to determine the effect of BMI. Results Logistic regression model analysis linked BMI and infertility after adjusting for potential confounders OR 1.03, 95%Cl: 1.02–1.05). There was a non-linear relationship between BMI and infertility, with each unit increase in BMI reducing the risk of infertility by 33% when BMI was <19.5 kg/m2. In contrast, when BMI ≥19.5 kg/m2, each unit increase in BMI predicted a 3% increase in the risk of infertility. Conclusion The relationship between infertility and BMI presented a U-shaped curve. Therefore, a BMI that lay at the extremes of the spectrum tended to predict infertility. We believe that this study will support the maintenance of suitable BMI levels in women preparing for pregnancy.
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Affiliation(s)
- Lei Zhu
- Thyroid Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Bin Zhou
- Thyroid Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Xi Zhu
- Thyroid Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Feng Cheng
- Thyroid Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Ying Pan
- Breast Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Yi Zhou
- Breast Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Yong Wu
- Thyroid Surgery Department, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
| | - Qingna Xu
- Health Care Office, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, Lishui City, Zhejiang Province, People’s Republic of China
- Correspondence: Qingna Xu, Health Care Office, The Fifth Hospital Affiliated to Wenzhou Medical University, Lishui Central Hospital, No. 289, Kuocang Road, Lishui City, Zhejiang Province, People’s Republic of China, Tel +86 13735910709, Email
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