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Customized estimated fetal weight: a novel antenatal tool to diagnose abnormal fetal growth

  • Benjamin A. Kase
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston, and Children's Memorial Hermann Hospital–Texas Medical Center, Houston, TX
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  • Carlos A. Carreno
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston, and Children's Memorial Hermann Hospital–Texas Medical Center, Houston, TX
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  • Sean C. Blackwell
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston, and Children's Memorial Hermann Hospital–Texas Medical Center, Houston, TX
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      Objective

      We sought to apply customized standards to ultrasound-derived estimated fetal weight (EFW), and assess the frequency of abnormal growth when compared to population-based standards. We also evaluated association with adverse perinatal outcomes.

      Study Design

      This was a historical cohort using prenatal ultrasound examination data at ≥24 weeks over a 1-year period. Ultrasound-derived EFW and growth percentile (population-based EFW [popEFW]) were reported and compared to a customized EFW (custEFW).

      Results

      In all, 782 women met inclusion criteria. More fetuses were identified as small for gestational age (SGA) (15.1% vs 3.8%; P < .0001) and large for gestational age (LGA) (6.8% vs 1.7%; P < .0001) using custEFW, and adverse perinatal outcomes were more frequent among those identified by the custEFW compared to the popEFW. Both SGA and LGA diagnosed by custEFW were predictive of a neonatal SGA (positive likelihood ratio, 8.64) and LGA (positive likelihood ratio, 15.4).

      Conclusion

      CustEFW was a better predictor of abnormal birthweight and adverse outcomes compared to traditional popEFW standards.

      Key words

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