Influence of ultrasound‐to‐delivery interval and maternal–fetal characteristics on validity of estimated fetal weight

• Published in: Ultrasound in obstetrics & gynecology Vol. 35; no. 4; pp. 434 - 441
• Main Authors: Cohen, J. M., Hutcheon, J. A., Kramer, M. S., Joseph, K. S., Abenhaim, H., Platt, R. W.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.04.2010; Wiley
• Subjects: Adult; Age; Biological and medical sciences; Birth Weight; Canada; Data processing; Delivery. Postpartum. Lactation; Female; Fetal Weight; Fetuses; Gestational Age; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infants; measurement error; Medical sciences; Obesity; Obstetrics; Predictive Value of Tests; Pregnancy; Pregnancy in Diabetics; Pregnancy Outcome; prenatal diagnosis; prenatal ultrasonography; Reference Values; Reproducibility of Results; sensitivity and specificity; Small-for-gestational age; Ultrasonography, Prenatal; Ultrasound; Canada; Performance evaluation; Sonography; Gynecology; Body weight; Error; Corporal biometry; Obstetrics; sensitivity and specificity; Pregnancy; Prenatal; Validity; measurement error; Prenatal diagnosis; Mother; Characteristics; Echography; fetal weight; Fetus; prenatal ultrasonography; Delivery; Ultrasound
• ISSN: 0960-7692; 1469-0705; 1469-0705
• DOI: 10.1002/uog.7506

Objectives To explore the effects of ultrasound‐to‐delivery interval and maternal–fetal characteristics on the distribution of measurement error in estimated fetal weights (EFWs), and to determine the predictive ability of EFW for diagnosis of small‐for‐gestational age (SGA) and large‐for‐gestational age (LGA) among infants delivered within 1 day of an ultrasound examination. Methods Percentage differences between EFW and birth weights were calculated in 3697 pregnancies. Linear regression was used to compare the accuracy of EFW for births on each of the 6 days after an ultrasound scan with the accuracy observed among births on the same day. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value for diagnosis of SGA and LGA according to EFW was assessed. Results The mean ± SD percentage difference among deliveries within 1 day of the last ultrasound scan was 0.2 ± 9.0%. Mean percentage differences were not significantly different from day 0 on days 1, 2 and 3; however, combining the data from these 4 days obscured a slight bias towards an overestimation of weight evident on day 0 and day 1. Among deliveries within 1 day of an ultrasound scan, the PPV was 61% for SGA diagnosis and 54% for LGA diagnosis. Conclusion Combining data from births > 1 day after the last ultrasound examination may lead to a false conclusion that there is systematic underestimation of weight. EFW tended to underestimate the weight of macrosomic fetuses and overestimate that of small fetuses which limited sensitivity and PPV. Maternal–fetal characteristics are weak predictors of individual errors in EFW. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.