Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter June 17, 2014

Predicting fetal growth deviation in parous women: combining the birth weight of the previous pregnancy and third trimester ultrasound scan

  • Ioannis Papastefanou EMAIL logo , Athena P. Souka , Makarios Eleftheriades , Athanasios Pilalis , Charalambos Chrelias and Dimitrios Kassanos

Abstract

Aim: To investigate the value of the birth weight of the previous pregnancy (BW1) alone and combined with the third trimester ultrasonographically estimated fetal weight (EFW) and Doppler studies in the prediction of small (SGA) and large for gestational age (LGA) neonates in the index pregnancy (BW2).

Method: Some 1298 parous women with uncomplicated singleton pregnancies who had a third trimester ultrasound scan were considered as samples in this retrospective cohort study. Maternal and pregnancy characteristics, BW1, EFW, umbilical artery, and middle cerebral artery pulsatility indices were investigated as predictors of SGA and LGA.

Results: BW1, maternal weight, mode of conception, and smoking status were associated with BW2 (R2=0.39) with BW1 being the strongest predictor (R2=0.37). The addition of EFW conferred significant improvement (R2=0.63), whereas the addition of the Doppler indices did not. The sensitivity of BW1 alone in the prediction of SGA was 75% for 25% screen positive rate and increased to 92% with the addition of EFW. The equivalent figures for LGA were 68% and 93%, respectively.

Conclusions: BW1 used as a continuous variable is predictive of growth deviations in the index pregnancy. Incorporating EFW enhanced the sensitivity for the detection of both conditions.


Corresponding author: Dr. Ioannis Papastefanou, 3rd Department of Obstetrics and Gynecology, “Attikon” University Hospital, Rimini 1, 124 62, Haidari, Athens, Greece, Tel.: +030-210-5832236, Fax: +030-210-5826447, E-mail:

References

[1] Ananth CV, Kaminsky L, Getahun D, Kirby RS, Vintzileos AM. Recurrence of fetal growth restriction in singleton and twin gestations. J Matern Fetal Neonat Med. 2009;22:654–61.10.1080/14767050902740207Search in Google Scholar

[2] Bjørstad AR, Irgens-Hansen K, Daltveit AK, Irgens LM. Macrosomia: mode of delivery and pregnancy outcome. Acta Obstet Gynecol Scand. 2010;89:664–9.10.3109/00016341003686099Search in Google Scholar

[3] Cheng CJ, Bommarito K, Noguchi A, Holcomb W, Leet T. Body mass index change between pregnancies and small for gestational age births. Obstet Gynecol. 2004;104:286–92.10.1097/01.AOG.0000134526.37657.b0Search in Google Scholar

[4] Cnattingius S, Forman MR, Berendes HW, Graubard BI, Isotalo L. Effect of age, parity, and smoking on pregnancy outcome: a population based study. Am J Obstet Gynecol. 1993;168:16–21.10.1016/S0002-9378(12)90878-9Search in Google Scholar

[5] Crispi F, Figueras F, Cruz-Lemini M, Bartrons J, Bijnens B, Gratacos E. Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severity. Am J Obstet Gynecol. 2012;207:121.e19.10.1016/j.ajog.2012.05.011Search in Google Scholar PubMed

[6] Das S, Irigoyen M, Patterson MB, Salvador A, Schutzman DL. Neonatal outcomes of macrosomic births in diabetic and non-diabetic women. Arch Dis Child Fetal Neonatal Ed. 2009;94:F419–22.10.1136/adc.2008.156026Search in Google Scholar PubMed

[7] Davis R, Woelk G, Mueller BA, Daling J. The role of previous birthweight on risk for macrosomia in a subsequent birth. Epidemiology. 1995;6:607–11.10.1097/00001648-199511000-00008Search in Google Scholar PubMed

[8] Ego A, Subtil D, Grange G, Thiebaugeorges O, Senat M, Vayssiere C, et al. Should parity be included in customised fetal weight standards for identifying small-for-gestational-age babies? Results from a French multicentre study. Br J Obstet Gynaecol. 2008;115:1256–64.10.1111/j.1471-0528.2008.01855.xSearch in Google Scholar PubMed

[9] Gardosi J, Clausson B, Francis A. The value of customised centiles in assessing perinatal mortality risk associated with parity and maternal size. Br J Obstet Gynaecol. 2009;116:1356–63.10.1111/j.1471-0528.2009.02245.xSearch in Google Scholar PubMed

[10] Getahun D, Ananth CV, Peltier MR, Salihu HM, Scorza WE. Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for gestational-age birth. Am J Obstet Gynecol. 2007;196:530.e1–8.10.1016/j.ajog.2006.12.036Search in Google Scholar PubMed

[11] 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;151:333–7.10.1016/0002-9378(85)90298-4Search in Google Scholar

[12] Illa M, Coloma JL, Eixarch E, Meler E, Iraola A, Gardosi J, et al. Growth deficit in term small-for-gestational fetuses with normal umbilical artery Doppler is associated with adverse outcome. J Perinat Med. 2009;37:48–52.10.1515/JPM.2009.003Search in Google Scholar

[13] Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2003;111:9–14.10.1016/S0301-2115(03)00154-4Search in Google Scholar

[14] Kacem Y, Cannie MM, Kadji C, Dobrescu O, Lo Zito L, Ziane S, et al. Fetal weight estimation: comparison of two-dimensional US and MR imaging assessments. Radiology. 2013;267:902–10.10.1148/radiol.12121374Search in Google Scholar PubMed

[15] Kayem G, Grangé G, Bréart G, Goffinet F. Comparison of fundal height measurement and sonographically measured fetal abdominal circumference in the prediction of high and low birth weight at term. Ultrasound Obstet Gynecol. 2009;34:566–71.10.1002/uog.6378Search in Google Scholar PubMed

[16] Kiely JL, Paneth N, Susser M. An assessment of the effects of maternal age and parity in different components of perinatal mortality. Am J Epidemiol. 1986;123:444–54.10.1093/oxfordjournals.aje.a114259Search in Google Scholar PubMed

[17] La Batide-Alanore A, Trégouët DA, Jaquet D, Bouyer J, Tiret L. Familial aggregation of fetal growth restriction in a French cohort of 7,822 term births between 1971 and 1985. Am J Epidemiol. 2002;156:180–7.10.1093/aje/kwf002Search in Google Scholar PubMed

[18] Lindqvist PG, Molin J. Does antenatal identification of small-for-gestational age fetuses significantly improve their outcome? Ultrasound Obstet Gynecol. 2005;25:258–64.10.1002/uog.1806Search in Google Scholar PubMed

[19] Lo Zito L, Kadji C, Cannie M, Kacem Y, Strizek B, Mbonyumutwa M, et al. Determination of fetal body volume measurement at term with magnetic resonance imaging: effect of various factors. J Matern Fetal Neonatal Med. 2013;26:1254–8.10.3109/14767058.2013.776537Search in Google Scholar PubMed

[20] McIntire DD, Bloom SL, Casey BM, Leveno KJ. Birthweight in relation to morbidity and mortality among newborn infants. N Engl J Med. 1999;340:1234–8.10.1056/NEJM199904223401603Search in Google Scholar PubMed

[21] Oros D, Figueras F, Cruz-Martinez R, Meler E, Munmany M, Gratacos E. Longitudinal changes in uterine, umbilical and fetal cerebral Doppler indices in late-onset small-for-gestational age fetuses. Ultrasound Obstet Gynecol. 2011;37:191–5.10.1002/uog.7738Search in Google Scholar

[22] Papastefanou I, Souka AP, Pilalis A, Eleftheriades M, Michalitsi V, Kassanos D. First trimester prediction of small and large for gestation neonates by an integrated model incorporating ultrasound parameters, biochemical indices and maternal characteristics. Acta Obstet Gynecol Scand. 2012;91:104–11.10.1111/j.1600-0412.2011.01271.xSearch in Google Scholar

[23] Persson B, Stangenberg M, Lunell NO, Holmberg NG, Vaclavinkova V. Prediction of size of infants at birth by measurement of symphysis fundus height. Br J Obstet Gynaecol. 1986;93:20611.10.1111/j.1471-0528.1986.tb07894.xSearch in Google Scholar

[24] Pilalis A, Souka AP, Papastefanou I, Michalitsi V, Panagopoulos P, Chrelias C, et al. Third trimester ultrasound for the prediction of the large for gestational age fetus in low-risk population and evaluation of contingency strategies. Prenat Diagn. 2012;32:846–53.10.1002/pd.3918Search in Google Scholar

[25] Salomon LJ, Bernard JP, Ville Y. Estimation of fetal weight: reference range at 20-36 weeks’ gestation and comparison with actual birth-weight reference range. Ultrasound Obstet Gynecol. 2007;29:550–5.10.1002/uog.4019Search in Google Scholar

[26] Savchev S, Sanz-Cortes M, Cruz-Martinez R, Arranz A, Botet F, Gratacos E, et al. Neurodevelopmental outcome of full-term, small-for-gestational-age infants with normal placental function. Ultrasound Obstet Gynecol. 2013;42:201–6.10.1002/uog.12391Search in Google Scholar

[27] Schild RL, Maringa M, Siemer J, Meurer B, Hart N, Goecke TW, et al. Weight estimation by three-dimensional ultrasound imaging in the small fetus. Ultrasound Obstet Gynecol. 2008;32:168–75.10.1002/uog.6111Search in Google Scholar

[28] Shoham-Vardi I, Leiberman JR, Kopernik G. The association of primiparity with intrauterine growth retardation. Eur J Obstet Gynecol Reprod Biol. 1994;53:95–101.10.1016/0028-2243(94)90214-3Search in Google Scholar

[29] Skjaerven R, Gjessing HK, Bakketeig LS. New standards for birth weight by gestational age using family data. Am J Obstet Gynecol. 2000;183:689–96.10.1067/mob.2000.106590Search in Google Scholar PubMed

[30] Souka AP, Papastefanou I, Michalitsi V, Pilalis A, Kassanos D. Specific formulas improve the estimation of fetal weight by ultrasound scan. J Matern Fetal Neonatal Med. 2014;27: 737–42.10.3109/14767058.2013.837877Search in Google Scholar PubMed

[31] Souka AP, Papastefanou I, Pilalis A, Michalitsi V, Kassanos D. Performance of third-trimester ultrasound for prediction of small-for-gestational-age neonates and evaluation of contingency screening policies. Ultrasound Obstet Gynecol. 2012;39:535–42.10.1002/uog.10078Search in Google Scholar PubMed

[32] Souka AP, Papastefanou I, Pilalis A, Michalitsi V, Panagopoulos P, Kassanos D. Performance of the ultrasound examination in the early and late third trimester for the prediction of birth weight deviations. Prenat Diagn. 2013;33:915–20.10.1002/pd.4161Search in Google Scholar PubMed

[33] Voskamp BJ, Kazemier BM, Ravelli AC, Schaaf J, Mol BW, Pajkrt E. Recurrence of small-for-gestational-age pregnancy: analysis of first and subsequent singleton pregnancies in The Netherlands. Am J Obstet Gynecol. 2013;208:374.e1–6.10.1016/j.ajog.2013.01.045Search in Google Scholar PubMed

[34] Winkvist A, Mogrenab I, Högberg U. Familial patterns in birth characteristics: impact on individual and population risks. Intern J Epidemiol. 1998;27:24854.10.1093/ije/27.2.248Search in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-11-11
Accepted: 2014-5-23
Published Online: 2014-6-17
Published in Print: 2015-7-1

©2015 by De Gruyter

Downloaded on 26.5.2024 from https://www.degruyter.com/document/doi/10.1515/jpm-2013-0308/html
Scroll to top button