TY - JOUR
T1 - Identifying fetal growth disorders using ultrasound in obese nulliparous women
AU - Dude, Annie M.
AU - Davis, Berkley
AU - Delaney, Katie
AU - Yee, Lynn M.
N1 - Funding Information:
LMY is supported by the NICHD [K12 HD050121-11]. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences [grant Number UL1TR001422]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Objective: We evaluated the ability of third trimester ultrasound to diagnose fetal growth disorders among obese women. Methods: This is a retrospective cohort study of obese nulliparous women who delivered term singleton neonates who had an ultrasound within 5 weeks of delivery. We characterized the sensitivity, specificity, positive predictive value and negative predictive value of ultrasound to detect large-for-gestational age (LGA) and small-for-gestational age (SGA) infants. Antenatally, LGA and SGA were defined as an ultrasound estimated fetal weight >90% or <10% based on the Hadlock formula. Postnatally, LGA or SGA designation was based on gestational age-based birthweight percentiles. Test characteristics were analyzed for the total cohort and by class of obesity (class II, body mass index [BMI] = 35.0–39.9 kg/m2 versus class III, BMI ≥ 40 kg/m2). We compared the area under the curve for receiver-operating characteristic (ROC) curves for different classes of obesity. Results: Of 690 women, 13 (1.9%) screened positive for SGA and 19 (2.8%) delivered an SGA neonate. In contrast, 158 (22.9%) screened positive for LGA and 97 (14.1%) delivered an LGA neonate. The sensitivity of ultrasound for SGA was 26.3% and the specificity was 98.8%. The sensitivity for LGA was 75.3% and the specificity was 85.7%. The ROC curves did not differ significantly for different classes of obesity (p =.69 for SGA, p =.75 for LGA). Conclusion: Ultrasound in obese women who delivered term pregnancies has a high specificity but poor sensitivity for SGA and a low positive predictive value for LGA.
AB - Objective: We evaluated the ability of third trimester ultrasound to diagnose fetal growth disorders among obese women. Methods: This is a retrospective cohort study of obese nulliparous women who delivered term singleton neonates who had an ultrasound within 5 weeks of delivery. We characterized the sensitivity, specificity, positive predictive value and negative predictive value of ultrasound to detect large-for-gestational age (LGA) and small-for-gestational age (SGA) infants. Antenatally, LGA and SGA were defined as an ultrasound estimated fetal weight >90% or <10% based on the Hadlock formula. Postnatally, LGA or SGA designation was based on gestational age-based birthweight percentiles. Test characteristics were analyzed for the total cohort and by class of obesity (class II, body mass index [BMI] = 35.0–39.9 kg/m2 versus class III, BMI ≥ 40 kg/m2). We compared the area under the curve for receiver-operating characteristic (ROC) curves for different classes of obesity. Results: Of 690 women, 13 (1.9%) screened positive for SGA and 19 (2.8%) delivered an SGA neonate. In contrast, 158 (22.9%) screened positive for LGA and 97 (14.1%) delivered an LGA neonate. The sensitivity of ultrasound for SGA was 26.3% and the specificity was 98.8%. The sensitivity for LGA was 75.3% and the specificity was 85.7%. The ROC curves did not differ significantly for different classes of obesity (p =.69 for SGA, p =.75 for LGA). Conclusion: Ultrasound in obese women who delivered term pregnancies has a high specificity but poor sensitivity for SGA and a low positive predictive value for LGA.
KW - Large for gestational age
KW - obesity
KW - pregnancy
KW - small for gestational age
KW - ultrasound
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U2 - 10.1080/14767058.2019.1648420
DO - 10.1080/14767058.2019.1648420
M3 - Article
C2 - 31340707
AN - SCOPUS:85070263732
VL - 34
SP - 1768
EP - 1773
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
SN - 1476-7058
IS - 11
ER -