Screening for fetal growth disorders by clinical exam in the era of obesity
Objective: To evaluate the performance of clinical estimation of fetal weight as a screening test for fetal growth disorders and then to estimate the effect of maternal body mass index (BMI) on its screening efficiency. Study Design: This was a retrospective cohort study of patients referred for thi...
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| Veröffentlicht in: | Journal of perinatology 2013-05, Vol.33 (5), p.352-357 |
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| creator | Goetzinger, K R Tuuli, M G Odibo, A O Roehl, K A Macones, G A Cahill, A G |
| description | Objective:
To evaluate the performance of clinical estimation of fetal weight as a screening test for fetal growth disorders and then to estimate the effect of maternal body mass index (BMI) on its screening efficiency.
Study Design:
This was a retrospective cohort study of patients referred for third trimester ultrasound for the indication of ‘size unequal to dates’. Patients with medical co-morbidities that may alter their
a priori
risk for fetal growth disorders were excluded. The incidence of fetal growth disorders as well as amniotic fluid disturbances was determined for each group and then compared across maternal BMI categories of dates and 1543 for the indication of size90th percentile and 13.5 and 96.7% for predicting BW |
| doi_str_mv | 10.1038/jp.2012.130 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3640749</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A349112487</galeid><sourcerecordid>A349112487</sourcerecordid><originalsourceid>FETCH-LOGICAL-c638t-dd6dad995bfb9c77baf55c7ec3c288baea67d458dd08a0e32f6120607ba754fb3</originalsourceid><addsrcrecordid>eNqNktuLEzEUxgdR3Lr65LsMCCJoa-6XF2FZvOGCD-pzyCRn2pRpUpOp2v_eDF2XVhaVPATy_c6Xc2uaxxgtMKLq1Xq7IAiTBaboTjPDTIo554zebWZIMjpXlImz5kEpa4QmUd5vzghFUkspZs3Hzy4DxBCXbZ9y28Noh3aZ049x1fpQUvaQS9vtWzeEGFwV4afdtCG24wpayLZNfZs6KGHcP2zu9XYo8Oj6Pm--vn3z5fL9_OrTuw-XF1dzJ6ga594Lb73WvOs77aTsbM-5k-CoI0p1FqyQnnHlPVIWASW9wAQJVEHJWd_R8-b1wXe76zbgHcQx28Fsc9jYvDfJBnOqxLAyy_TdUMFqS3Q1eH5tkNO3HZTRbEJxMAw2QtoVg5WWVHHMyb9RqjViijD5HyiThCvCJ_TpH-g67XKsTTOk5sg1EUL_japeQtSeiCOvpR3AhNinWrObvjYXlGmMCVMTtbiFqsfDJrgUoQ_1_STg2VHACuwwrkoadmNIsZyCLw6gy6mUDP3NIDAy04Ka9dZMC1qTRpV-cjy7G_b3Rlbg5QEoVYpLyEdF3-L3C5GP67M</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1346606067</pqid></control><display><type>article</type><title>Screening for fetal growth disorders by clinical exam in the era of obesity</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Goetzinger, K R ; Tuuli, M G ; Odibo, A O ; Roehl, K A ; Macones, G A ; Cahill, A G</creator><creatorcontrib>Goetzinger, K R ; Tuuli, M G ; Odibo, A O ; Roehl, K A ; Macones, G A ; Cahill, A G</creatorcontrib><description>Objective:
To evaluate the performance of clinical estimation of fetal weight as a screening test for fetal growth disorders and then to estimate the effect of maternal body mass index (BMI) on its screening efficiency.
Study Design:
This was a retrospective cohort study of patients referred for third trimester ultrasound for the indication of ‘size unequal to dates’. Patients with medical co-morbidities that may alter their
a priori
risk for fetal growth disorders were excluded. The incidence of fetal growth disorders as well as amniotic fluid disturbances was determined for each group and then compared across maternal BMI categories of <25 kg m
−2
, 25–30 kg m
−2
, ⩾30 kg m
−2
and ⩾40 kg m
−2
. To evaluate the accuracy of clinical estimation of fetal weight in predicting fetal growth disorders, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, as well as number needed to scan (NNS) was calculated and compared across BMI categories.
Result:
Of 51 366 patients, 1623 were referred for the indication of size>dates and 1543 for the indication of size<dates. The incidence of fetal growth disorders in each referral group was low and was not significantly different across BMI categories. The sensitivity and specificity were 9.7 and 96.6% for predicting neonatal birth weight (BW)>90th percentile and 13.5 and 96.7% for predicting BW<10th percentile. The NNS to detect one neonate with a BW<10th percentile ranged from 5 to 19, whereas the NNS to detect one neonate with a BW>90th percentile ranged from 6 to 13 across BMI categories.
Conclusion:
Overall, clinical estimation of fetal weight yields a low detection rate of fetal growth abnormalities; however, its screening efficiency is not adversely impacted by maternal BMI.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/jp.2012.130</identifier><identifier>PMID: 23079776</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/699/2743/1530 ; 692/699/2743/393 ; 692/700/1720 ; Abnormalities ; Adult ; Amniotic fluid ; Birth weight ; Body mass ; Body Mass Index ; Body size ; Categories ; Cohort analysis ; Diabetes ; Disorders ; Ethnicity ; Female ; Fetal Growth Retardation - diagnostic imaging ; Fetal Macrosomia - diagnostic imaging ; Fetal Weight ; Fetus ; Fetuses ; Growth ; Growth retardation ; Gynecology ; Humans ; Indication ; Infants (Newborn) ; Likelihood ratio ; Measurement techniques ; Medical examination ; Medicine ; Medicine & Public Health ; Morbidity ; Neonates ; Obesity ; Obstetrics ; original-article ; Patients ; Pediatric Surgery ; Pediatrics ; Performance evaluation ; Physical growth ; Pregnancy ; Prenatal care ; Retrospective Studies ; Sensitivity ; Sensitivity and Specificity ; Ultrasonic imaging ; Ultrasonography, Prenatal ; Weight</subject><ispartof>Journal of perinatology, 2013-05, Vol.33 (5), p.352-357</ispartof><rights>Nature America, Inc. 2012</rights><rights>COPYRIGHT 2013 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group May 2013</rights><rights>Nature America, Inc. 2012.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c638t-dd6dad995bfb9c77baf55c7ec3c288baea67d458dd08a0e32f6120607ba754fb3</citedby><cites>FETCH-LOGICAL-c638t-dd6dad995bfb9c77baf55c7ec3c288baea67d458dd08a0e32f6120607ba754fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/jp.2012.130$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/jp.2012.130$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23079776$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goetzinger, K R</creatorcontrib><creatorcontrib>Tuuli, M G</creatorcontrib><creatorcontrib>Odibo, A O</creatorcontrib><creatorcontrib>Roehl, K A</creatorcontrib><creatorcontrib>Macones, G A</creatorcontrib><creatorcontrib>Cahill, A G</creatorcontrib><title>Screening for fetal growth disorders by clinical exam in the era of obesity</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective:
To evaluate the performance of clinical estimation of fetal weight as a screening test for fetal growth disorders and then to estimate the effect of maternal body mass index (BMI) on its screening efficiency.
Study Design:
This was a retrospective cohort study of patients referred for third trimester ultrasound for the indication of ‘size unequal to dates’. Patients with medical co-morbidities that may alter their
a priori
risk for fetal growth disorders were excluded. The incidence of fetal growth disorders as well as amniotic fluid disturbances was determined for each group and then compared across maternal BMI categories of <25 kg m
−2
, 25–30 kg m
−2
, ⩾30 kg m
−2
and ⩾40 kg m
−2
. To evaluate the accuracy of clinical estimation of fetal weight in predicting fetal growth disorders, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, as well as number needed to scan (NNS) was calculated and compared across BMI categories.
Result:
Of 51 366 patients, 1623 were referred for the indication of size>dates and 1543 for the indication of size<dates. The incidence of fetal growth disorders in each referral group was low and was not significantly different across BMI categories. The sensitivity and specificity were 9.7 and 96.6% for predicting neonatal birth weight (BW)>90th percentile and 13.5 and 96.7% for predicting BW<10th percentile. The NNS to detect one neonate with a BW<10th percentile ranged from 5 to 19, whereas the NNS to detect one neonate with a BW>90th percentile ranged from 6 to 13 across BMI categories.
Conclusion:
Overall, clinical estimation of fetal weight yields a low detection rate of fetal growth abnormalities; however, its screening efficiency is not adversely impacted by maternal BMI.</description><subject>692/699/2743/1530</subject><subject>692/699/2743/393</subject><subject>692/700/1720</subject><subject>Abnormalities</subject><subject>Adult</subject><subject>Amniotic fluid</subject><subject>Birth weight</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body size</subject><subject>Categories</subject><subject>Cohort analysis</subject><subject>Diabetes</subject><subject>Disorders</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Fetal Macrosomia - diagnostic imaging</subject><subject>Fetal Weight</subject><subject>Fetus</subject><subject>Fetuses</subject><subject>Growth</subject><subject>Growth retardation</subject><subject>Gynecology</subject><subject>Humans</subject><subject>Indication</subject><subject>Infants (Newborn)</subject><subject>Likelihood ratio</subject><subject>Measurement techniques</subject><subject>Medical examination</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Neonates</subject><subject>Obesity</subject><subject>Obstetrics</subject><subject>original-article</subject><subject>Patients</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Performance evaluation</subject><subject>Physical growth</subject><subject>Pregnancy</subject><subject>Prenatal care</subject><subject>Retrospective Studies</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Prenatal</subject><subject>Weight</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNktuLEzEUxgdR3Lr65LsMCCJoa-6XF2FZvOGCD-pzyCRn2pRpUpOp2v_eDF2XVhaVPATy_c6Xc2uaxxgtMKLq1Xq7IAiTBaboTjPDTIo554zebWZIMjpXlImz5kEpa4QmUd5vzghFUkspZs3Hzy4DxBCXbZ9y28Noh3aZ049x1fpQUvaQS9vtWzeEGFwV4afdtCG24wpayLZNfZs6KGHcP2zu9XYo8Oj6Pm--vn3z5fL9_OrTuw-XF1dzJ6ga594Lb73WvOs77aTsbM-5k-CoI0p1FqyQnnHlPVIWASW9wAQJVEHJWd_R8-b1wXe76zbgHcQx28Fsc9jYvDfJBnOqxLAyy_TdUMFqS3Q1eH5tkNO3HZTRbEJxMAw2QtoVg5WWVHHMyb9RqjViijD5HyiThCvCJ_TpH-g67XKsTTOk5sg1EUL_japeQtSeiCOvpR3AhNinWrObvjYXlGmMCVMTtbiFqsfDJrgUoQ_1_STg2VHACuwwrkoadmNIsZyCLw6gy6mUDP3NIDAy04Ka9dZMC1qTRpV-cjy7G_b3Rlbg5QEoVYpLyEdF3-L3C5GP67M</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Goetzinger, K R</creator><creator>Tuuli, M G</creator><creator>Odibo, A 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R</creatorcontrib><creatorcontrib>Tuuli, M G</creatorcontrib><creatorcontrib>Odibo, A O</creatorcontrib><creatorcontrib>Roehl, K A</creatorcontrib><creatorcontrib>Macones, G A</creatorcontrib><creatorcontrib>Cahill, A G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 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perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>33</volume><issue>5</issue><spage>352</spage><epage>357</epage><pages>352-357</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>Objective:
To evaluate the performance of clinical estimation of fetal weight as a screening test for fetal growth disorders and then to estimate the effect of maternal body mass index (BMI) on its screening efficiency.
Study Design:
This was a retrospective cohort study of patients referred for third trimester ultrasound for the indication of ‘size unequal to dates’. Patients with medical co-morbidities that may alter their
a priori
risk for fetal growth disorders were excluded. The incidence of fetal growth disorders as well as amniotic fluid disturbances was determined for each group and then compared across maternal BMI categories of <25 kg m
−2
, 25–30 kg m
−2
, ⩾30 kg m
−2
and ⩾40 kg m
−2
. To evaluate the accuracy of clinical estimation of fetal weight in predicting fetal growth disorders, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, as well as number needed to scan (NNS) was calculated and compared across BMI categories.
Result:
Of 51 366 patients, 1623 were referred for the indication of size>dates and 1543 for the indication of size<dates. The incidence of fetal growth disorders in each referral group was low and was not significantly different across BMI categories. The sensitivity and specificity were 9.7 and 96.6% for predicting neonatal birth weight (BW)>90th percentile and 13.5 and 96.7% for predicting BW<10th percentile. The NNS to detect one neonate with a BW<10th percentile ranged from 5 to 19, whereas the NNS to detect one neonate with a BW>90th percentile ranged from 6 to 13 across BMI categories.
Conclusion:
Overall, clinical estimation of fetal weight yields a low detection rate of fetal growth abnormalities; however, its screening efficiency is not adversely impacted by maternal BMI.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>23079776</pmid><doi>10.1038/jp.2012.130</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0743-8346 |
| ispartof | Journal of perinatology, 2013-05, Vol.33 (5), p.352-357 |
| issn | 0743-8346 1476-5543 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3640749 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | 692/699/2743/1530 692/699/2743/393 692/700/1720 Abnormalities Adult Amniotic fluid Birth weight Body mass Body Mass Index Body size Categories Cohort analysis Diabetes Disorders Ethnicity Female Fetal Growth Retardation - diagnostic imaging Fetal Macrosomia - diagnostic imaging Fetal Weight Fetus Fetuses Growth Growth retardation Gynecology Humans Indication Infants (Newborn) Likelihood ratio Measurement techniques Medical examination Medicine Medicine & Public Health Morbidity Neonates Obesity Obstetrics original-article Patients Pediatric Surgery Pediatrics Performance evaluation Physical growth Pregnancy Prenatal care Retrospective Studies Sensitivity Sensitivity and Specificity Ultrasonic imaging Ultrasonography, Prenatal Weight |
| title | Screening for fetal growth disorders by clinical exam in the era of obesity |
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