False diagnosis of small for gestational age and macrosomia – clinical and sonographic predictors. (18th April 2022)

• Record Type: Journal Article
• Authors: Bardin, Ron; Aviram, Amir; Hiersch, Liran; Hadar, Eran; Gabbay-Benziv, Rinat
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 8(2022)
• Page Start: 1539
• Page End: 1545
• Publication Date: 2022-04-18
• Subjects: Small for gestational age -- estimated fetal weight -- fetal growth restriction -- fetal biometry -- macrosomia -- false diagnosis; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2020.1762559
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Purpose: To investigate clinical and sonographic features associated with sonographic accuracy for the prediction of small for gestational age (SGA) and macrosomia at birth. Methods: The database of a tertiary medical center was retrospectively searched for women who gave birth at term to a singleton healthy neonate in 2007–2014 and underwent sonographic estimated fetal weight (sEFW) evaluation within 3 d before delivery. Fetal growth restriction (FGR) and SGA were defined as sEFW or birth weight <10th percentile for gestational age; macrosomia was defined as birth weight >4000 grams. Data on maternal age, parity, gestational age, fetal gender, presentation, placental location, diabetes, hypertension, and oligo/polyhydramnios were compared between pregnancies with a false-negative and false-positive diagnosis of SGA or macrosomia. Results: Of the 5425 fetal weight evaluations, 254 (4.7%) deviated by >15% from the actual birth weight. Nulliparity, absence of diabetes, neonatal female gender, anterior placenta, lower birth weight, and oligohydramnios were associated with a high deviation. We identified 482 SGA neonates (8.9%) and 633 macrosomic neonates (11.7%). A false-positive diagnosis of FGR was associated with oligohydramnios, absence of diabetes, and posterior placenta, and a false-negative diagnosis, with older maternal age, nulliparity, and male gender. A false-positive diagnosis of macrosomia was associated with older maternal age, multiparity, polyhydramnios, anterior placenta, and lack of hypertensive complications, and a false-negative diagnosis, with diabetes, hypertension, oligohydramnios, and vertex presentation. Conclusion: The accuracy of sEFW is affected by clinical and sonographic pregnancy characteristics. Further analyses should focus on improving accuracy especially at the fetal weight extremes.