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Predicting birth weight in fetuses with gastroschisis

Journal of Perinatology volume 38, pages 122–126 (2018)Cite this article

Subjects

Abstract

Objective:

To determine the accuracy of commonly utilized ultrasound formulas for estimating birth weight (BW) in fetuses with gastroschisis.

Study Design:

A retrospective review was conducted of all inborn pregnancies with gastroschisis within the five institutions of the University of California Fetal Consortium (UCfC) between 2007 and 2012. Infants delivered at ⩾28 weeks who had an ultrasound within 21 days before delivery were included. Prediction of BW was evaluated for each of the five ultrasound formulas: Hadlock 1 (abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC)) and Hadlock 2 (AC, BPD and FL), Shepard (AC and BPD), Honarvar (FL) and Siemer (BPD, occipitofrontal diameter (OFD), and FL) using Pearson’s correlation, mean difference and percent error and Bland–Altman analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the ultrasound diagnosis of intrauterine growth restriction (IUGR) were assessed.

Results:

We identified 191 neonates born with gastroschisis within the UCfC, with 111 neonates meeting the inclusion criteria. The mean gestational age at delivery was 36.3±1.7 weeks and the mean BW was 2448±460 g. Hadlock (1) formula was found to have the best correlation (r=0.81), the lowest mean difference (8±306 g) and the lowest mean percent error (1.4±13%). The Honarvar and Siemer formulas performed significantly worse when compared with Hadlock 1, with a 13.7% (P<0.001) and 3.9% (P=0.03) difference, respectively, between estimated and actual BW. This was supported by Bland–Altman plots. For Hadlock 1 and 2, sensitivity was 80% with a NPV of 91%.

Conclusion:

The widely used Hadlock (1) and (2) formulas provided the best estimated BW in infants with gastroschisis despite its inclusion of abdominal circumference. Furthermore, this formula performs well with diagnosis of IUGR.

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References

  1. Kirby RS, Marshall J, Tanner JP, Salemi JL, Feldkamp ML, Marengo L et al. Prevalence and correlates of gastroschisis in 15 states, 1995 to 2005. Obstet Gynecol 2013; 122: 275–281.

    Article  Google Scholar 

  2. Jones AM, Isenburg J, Salemi JL, Arnold KE, Mai CT, Aggarwal D et al. Increasing prevalence of gastroschisis—14 States, 1995-2012. MMWR Morb Mortal Wkly Rep 2016; 65: 23–26.

    Article  Google Scholar 

  3. Vu LT, Nobuhara KK, Laurent C, Shaw GM . Increasing prevalence of gastroschisis: population-based study in California. J Pediatr 2008; 152 (6): 807–811.

    Article  Google Scholar 

  4. Laughon M, Meyer R, Bose C, Wall A, Otero E, Heerens A et al. Rising birth prevalence of gastroschisis. J Perinatol 2003; 23 (4): 291–293.

    Article  Google Scholar 

  5. Santiago-Munoz PC, McIntire DD, Barber RG, Megison SM, Twickler DM, Dashe JS . Outcomes of pregnancies with fetal gastroschisis. Obstet Gynecol 2007; 110 (3): 663–668.

    Article  Google Scholar 

  6. Netta DA, Wilson RD, Visintainer P, Johnson MP, Hendrick HL, AW Flake et al. Gastroschisis: growth patterns and a proposed prenatal surveillance protocol. Fetal Diagn Ther 2007; 22 (5): 352–357.

    Article  Google Scholar 

  7. Raynor BD, Richards D . Growth restriction in fetuses with gastroschisis. J Ultrasound Med 1997; 16 (1): 13–16.

    Article  CAS  Google Scholar 

  8. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK . Estimation of fetal weight with the use of head, body, and femur measurements: a prospective study. Am J Obstet Gynecol 1985; 151 (3): 333–337.

    Article  CAS  Google Scholar 

  9. Shepard MJ, Richards VA, Berkowitz RL, Warsof SL, Hobbins JC . An evaluation of two equations for predicting fetal weight by ultrasound. Am J Obstet Gynecol 1982; 142 (1): 47–54.

    Article  CAS  Google Scholar 

  10. Honarvar M, Allahyari M, Dehbashi S . Assessment of fetal weight based on ultrasonic femur length after the second trimester. Int J Gynaecol Obstet 2001; 73 (1): 15–20.

    Article  CAS  Google Scholar 

  11. Siemer J, Hilbert A, Hart N, Hoopmann M, Schneider U, Girschick G et al. Specific weight formula for fetuses with abdominal wall defects. Ultrasound Obstet Gynecol 2008; 31 (4): 397–400.

    Article  CAS  Google Scholar 

  12. Warsof SL, Gohari P, Berkowitz RL, Hobbins JC . The estimation of fetal weight by computer-assisted analysis. Am J Obstet Gynecol 1977; 128 (8): 881–892.

    Article  CAS  Google Scholar 

  13. Owen P, Donnet ML, Ogston SA, Christie AD, Howie PW, Patel NB . Standards for ultrasound fetal growth velocity. Br J Obstet Gynaecol 1996; 103 (1): 60–69.

    Article  CAS  Google Scholar 

  14. Fenton TR, Nasser R, Eliasziw M, Kim JH, Bilan D, Sauve R . Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr 2013; 13: 92.

  15. American College of Obstetricians and Gynecologists. Practice Bulletin No. 134: Fetal growth restriction. Obstet Gynecol 2013; 121 (5): 1122–1133.

    Article  Google Scholar 

  16. Nicholas S, Tuuli MG, Dicke J, Macones GA, Stamilio D, Odibo AO . Estimation of fetal weight in fetuses with abdominal wall defects. J Ultrasound Med 2010; 29 (7): 1069–1074.

    Article  Google Scholar 

  17. Chaudhury P, Haeri S, Horton AL, Wolfe HM, Goodnight WH . Ultrasound prediction of birthweight and growth restriction in fetal gastroschisis. Am J Obstet Gynecol 2010; 203 (4): 395.e1–5.

    Article  Google Scholar 

  18. Sparks TN, Shaffer BL, Page J, Caughey AB . Gastroschisis: mortality risks with each additional week of expectant management. Am J Obstet Gynecol 2017; 216 (1): 66.e1–66.e7.

    Article  Google Scholar 

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Acknowledgements

This study was presented in poster format on 5 February 2016 at the 36th Annual Meeting of the Society of Maternal Fetal Medicine, Atlanta, Georgia held on 1–7 February 2016.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA

    M N Zaki & M Porto

  2. Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA

    L A Lusk & M Liebowitz

  3. Division of Maternal-Fetal Medicine, Department of Reproductive Medicine, University of California, San Diego, San Diego, CA, USA

    R T Overcash

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA

    R T Overcash

  5. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA, USA

    R Rao

  6. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Davis, Davis, CA, USA

    Y N Truong

  7. Kaiser Permanente San Leandro, San Leandro, CA, USA

    Y N Truong

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  1. M N Zaki
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for the University of California Fetal Consortium (UCfC)

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Correspondence to M N Zaki.

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Zaki, M., Lusk, L., Overcash, R. et al. Predicting birth weight in fetuses with gastroschisis. J Perinatol 38, 122–126 (2018). https://doi.org/10.1038/jp.2017.171

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