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Prediction of large for gestational age by various sonographic fetal weight estimation formulas—which should we use?

Journal of Perinatology volume 37, pages 513–517 (2017)Cite this article

Subjects

Abstract

Objective:

As sonographic estimation of fetal weight (EFW) carries substantial impact, especially in large-for-gestational-age (LGA) neonates, we aimed to compare the accuracy of various formulas for prediction of LGA neonates.

Study Design:

Retrospective cohort study of singleton gestations at term, with EFW up to 7 days before delivery (2007 to 2014). Small-for-gestational-age neonates were excluded. LGA prediction for various formulas was evaluated by: (i) measures of performance (sensitivity, specificity, etc.); (ii) systematic and random errors (SE and RE) and the proportion of estimates (POEs) exceeding 10% of actual birth weight. Best performing formula was defined as the one with the lowest Euclidean distance [=square root of (SE2+RE2)].

Results:

Out of 62 102 deliveries, 7996 met inclusion criteria, of which 1618 neonates were LGA (22%). There was a considerable variation in sensitivity (74.6±16.3%, 23.5% to 99%), specificity (86.3±10.6%, 51.7% to 99.6%), positive predictive value (64.9±12.4%, 35.6% to 93.8%), positive likelihood ratio (LR; 9.3±10.9, 2.1 to 54.2) and negative LR (0.3±0.16, 0.02 to 0.8), a mild variation in the negative predictive value (92.9±3.7%, 82.3% to 99.5%) and a minimal variation in the area under the curve (94.3%, 93.0 to 95.1; mean±s.d., range for all). Absolute SE was higher for the LGA group in 11/20 formulas (55%). The RE and POE were lower in 19/20 (95%) and 14/20 (70%) for the LGA neonates, respectively.

Conclusion:

There is a wide variation in EFW formulas performance for detecting LGA. Hadlock’s formula (1985) combining abdominal circumference, femur length and biparietal diameter ranked highest.

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Authors and Affiliations

  1. Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    A Aviram, Y Yogev, E Ashwal & L Hiersch

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    A Aviram, Y Yogev, E Ashwal, L Hiersch, E Hadar & R Gabbay-Benziv

  3. Helen Schneider Hospital for Women, Rabin Medical Center, Petah-Tikva, Israel

    E Hadar & R Gabbay-Benziv

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  1. A Aviram
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  2. Y Yogev
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  4. L Hiersch
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Correspondence to A Aviram.

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Additional information

The abstract of this manuscript was presented as a poster presentation at the SMFM annual meeting in Atlanta, Georgia, USA, February 2016.

Supplementary Information accompanies this paper on the Journal of Perinatology website

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Aviram, A., Yogev, Y., Ashwal, E. et al. Prediction of large for gestational age by various sonographic fetal weight estimation formulas—which should we use?. J Perinatol 37, 513–517 (2017). https://doi.org/10.1038/jp.2017.5

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