Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population
| Autor: | Tri Rahmat Basuki, Javier Caradeux, Eduard Gratacós, Elisenda Eixarch, Francesc Figueras, Edurne Mazarico |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Embryology medicine.medical_specialty Pregnancy Trimester Third Population Gestational Age Standard score Third trimester Ultrasonography Prenatal Fetal Macrosomia Fetal Development 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine education education.field_of_study 030219 obstetrics & reproductive medicine Receiver operating characteristic Singleton Obstetrics business.industry Longitudinal growth Obstetrics and Gynecology Gestational age General Medicine Cross-Sectional Studies Fetal Weight Pregnancy Trimester Second Pediatrics Perinatology and Child Health Cohort Female business |
| Zdroj: | Fetal Diagnosis and Therapy. 43:284-290 |
| ISSN: | 1421-9964 1015-3837 |
| DOI: | 10.1159/000477460 |
| Popis: | Background: Prenatal detection of excessive growth remains inaccurate. Most strategies rely on a single cross-sectional evaluation of fetal size during the third trimester. Objectives: To compare second- to third-trimester longitudinal growth assessment with cross-sectional evaluation at the third trimester in the prediction of largeness for gestational age (LGA) and macrosomia. Methods: A cohort of 2,696 unselected singleton pregnancies scanned at 21 ± 2 and 32 ± 2 weeks was created. Abdominal circumference (AC) measurements were transformed to z values according to the INTERGROWTH-21st standards. Longitudinal growth assessment was performed by calculation of z velocity and conditional growth. Both methods were compared to cross-sectional assessment at 32 ± 2 weeks. Predictive performance for LGA and macrosomia was determined by receiver operating characteristic curve analysis. Result: A total of 188 (7%) newborns qualified for LGA and 182 (6.8%) for macrosomia. The areas under the curve (AUCs) for 32-week AC z score, AC z velocity, and conditional AC were 0.78, 0.61, and 0.55, respectively, for the prediction of LGA, and 0.75, 0.61, and 0.55, respectively, for the prediction of macrosomia. Both AUCs of AC z velocity and conditional AC were significantly lower (p < 0.001) than the AUC of cross-sectional AC z scores. Conclusions: In the general population, second- to third-trimester longitudinal assessment of fetal growth is inferior to third-trimester cross-sectional evaluation of size in the prediction of LGA and macrosomia. |
| Databáze: | OpenAIRE |
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