Variation in the definition of intrauterine growth restriction in routine antenatal care: a physician survey among gynecologists in Northwest Germany. (18th August 2018)

• Record Type: Journal Article
• Authors: Ernst, Sinja Alexandra; Brand, Tilman; Petersen, Knud; Zeeb, Hajo
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 16(2018)
• Page Start: 2141
• Page End: 2147
• Publication Date: 2018-08-18
• Subjects: Antenatal detection -- antenatal diagnosis -- intrauterine growth restriction -- physician survey -- prenatal care -- small for gestational age; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1337739
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To assess how intrauterine growth restriction (IUGR) is defined by gynecologists in routine practice. Materials and methods: We surveyed primary care gynecologists in Bremen and Lower Saxony, Northwest Germany, between January and July 2014. Descriptive statistics were used to analyze the data; consensus was considered as 90% agreement among the respondents. Multiple logistic regression models were performed for the associations between respondents' background characteristics and choice of the small for gestational age (SGA) cutoff values. Results: Overall, 185 primary care gynecologists participated in the survey. Consensus was only observed in two items: (1) an accurate determination of gestational age (91%) and (2) repeated measurement of the abdominal circumference (91%). Umbilical artery Doppler (76%) and repeated ultrasonography (76%) were the most frequently used methods to confirm suspected IUGR diagnoses, but different responses prevailed. Notably, only 46% of the respondents opted for the 10th percentile of estimated fetal weight as a cutoff for SGA classification, which is the internationally recommended value. Conclusions: The results of this survey indicate considerable practice variation regarding detection and management of IUGR pregnancies. There is a need for better agreement in terminology and definition of core aspects of IUGR in antenatal care.