Association of third-trimester abdominal circumference with provider-initiated preterm delivery. (August 2014)

• Record Type: Journal Article
• Authors: Hawkins, Leah K.; Schnettler, William T.; Modest, Anna M.; Hacker, Michele R.; Rodriguez, Diana
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 12(2014:Dec.)
• Page Start: 1228
• Page End: 1231
• Publication Date: 2014-08
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.852171
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: Evaluate the association of a small third-trimester abdominal circumference (AC < 10th percentile) in the setting of a normal estimated fetal weight (EFW ≥ 10th percentile) with gestational age at delivery, indication for delivery and neonatal outcomes.</p> <p> <italic>Methods</italic>: Retrospective cohort study at an academic hospital of women with singleton pregnancy seen for ultrasound from 28+0–33+6 weeks of gestation during 2009–2011. Outcomes were compared between two groups: normal AC (AC and EFW ≥ 10th percentile) and small AC (AC < 10th percentile and EFW ≥ 10th percentile).</p> <p> <italic>Results</italic>: Among 592 pregnancies, fetuses in the small AC group (<italic>n</italic> = 55) experienced a higher incidence of overall preterm delivery (RR: 2.2, 95% CI: 1.3–3.7) and provider-initiated preterm delivery (RR: 3.7, CI: 1.8–7.5) compared to those in the normal AC group (<italic>n</italic> = 537). Neonates in the small AC group had a lower median birth weight whether delivered at term (<italic>p</italic> < 0.001) or preterm (<italic>p</italic> = 0.04), but were not more likely to experience intensive care unit admission or respiratory distress syndrome (all <italic>p</italic> ≥ 0.35).</p> <p> <italic>Conclusions</italic>: Small AC, even in the setting of an EFW ≥ 10th percentile, was associated with a higher incidence of overall and provider-initiated preterm delivery despite similar neonatal outcomes. Further investigation is warranted to determine whether these preterm deliveries could be prevented.</p> </abstract>