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Percent error of ultrasound examination to estimate fetal weight at term in different categories of birth weight with focus on maternal diabetes and obesity. | LitMetric

AI Article Synopsis

  • The study explored how factors like diabetes, obesity, and excess weight gain impact the accuracy of ultrasound estimates of fetal weight, which is essential for planning deliveries.
  • It involved analyzing data from over 11,000 term deliveries and found that while diabetes, obesity, and weight gain didn't significantly change the overall accuracy, preexisting diabetes was associated with a higher rate of large babies (macrosomia).
  • The findings indicate that the percent error in estimated fetal weight varies with birth weight, demonstrating more overestimations in lower weight ranges and underestimations in higher ranges, emphasizing the need for careful monitoring at both ends.

Article Abstract

Background: Sonography based estimate of fetal weight is a considerable issue for delivery planning. The study evaluated the influence of diabetes, obesity, excess weight gain, fetal and neonatal anthropometrics on accuracy of estimated fetal weight with respect to the extent of the percent error of estimated fetal weight to birth weight for different categories.

Methods: Multicenter retrospective analysis from 11,049 term deliveries and fetal ultrasound biometry performed within 14 days to delivery. Estimated fetal weight was calculated by Hadlock IV. Percent error from birth weight was determined for categories in 250 g increments between 2500 g and 4500 g. Estimated fetal weight accuracy was categorized as accurate ≤ 10% of birth weight, under- and overestimated by >  ± 10% - ± 20% and > 20%.

Results: Diabetes was diagnosed in 12.5%, obesity in 12.6% and weight gain exceeding IOM recommendation in 49.1% of the women. The percentage of accurate estimated fetal weight was not significantly different in the presence of maternal diabetes (70.0% vs. 71.8%, p = 0.17), obesity (69.6% vs. 71.9%, p = 0.08) or excess weight gain (71.2% vs. 72%, p = 0.352) but of preexisting diabetes (61.1% vs. 71.7%; p = 0.007) that was associated with the highest macrosomia rate (26.9%). Mean percent error of estimated fetal weight from birth weight was 2.39% ± 9.13%. The extent of percent error varied with birth weight with the lowest numbers for 3000 g-3249 g and increasing with the extent of birth weight variation: 5% ± 11% overestimation in the lowest and 12% ± 8% underestimation in the highest ranges.

Conclusion: Diabetes, obesity and excess weight gain are not necessarily confounders of estimated fetal weight accuracy. Percent error of estimated fetal weight is closely related to birth weight with clinically relevant over- and underestimation at both extremes. This work provides detailed data regarding the extent of percent error for different birth weight categories and may therefore improve delivery planning.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944112PMC
http://dx.doi.org/10.1186/s12884-022-04519-zDOI Listing

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