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- W4295772806 abstract "Prenatal prediction of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) neonates allows providers to prepare for potential complications. We compared four methods' ability to predict SGA and LGA in gravidas with obesity. This was a prospective cohort study of gravidas admitted for delivery. We included patients with a body mass index (BMI) ≥ 30 kg/m2 and singleton, non-anomalous pregnancies ≥ 37 weeks. Exclusion criteria were polyhydramnios, active labour, and rupture of membranes. Four different approaches to obtain estimated fetal weight (EFW) were tested: (1) ultrasound (US) biometry performed upon admission, (2) clinician Leopold manoeuvres, (3) fundal height (FH) on admission, and (4) US EFW performed within 28 days of delivery. Predicted SGA and LGA were defined based on EFW and abdominal circumference percentile for US, EFW percentile for Leopold, and ≥ 3 cm fundal height discrepancy from gestational weeks. Neonatal SGA and LGA were defined using sex-specific birthweight curves. Receiver-operating characteristic curves were plotted, and area under the curves (AUC) calculated. AUCs were compared between EFW approaches and between BMI classes, as defined by Centers for Disease Control and Prevention. 250 patients were enrolled with a median BMI of 36.4 (IQR 32.7-41.3). Admission US maximised sensitivity and AUC for SGA and LGA. Leopold had high specificity for both SGA and LGA but poor sensitivity, with AUC of 0.60 and 0.54, respectively. Fundal height was moderately predictive of LGA, but poorly predictive of SGA. The AUC of admission US for SGA and LGA was equally high across BMI class (p = 0.91 and 0.11, respectively). In gravidas with obesity, Leopold manoeuvres and fundal height are poorly predictive of abnormal birthweight. Consideration should be made for universal US for fetal weight assessment at the time of admission for delivery." @default.
- W4295772806 created "2022-09-15" @default.
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- W4295772806 date "2022-09-01" @default.
- W4295772806 modified "2023-09-27" @default.
- W4295772806 title "EP37.32: Prediction of SGA and LGA neonates in gravidas with obesity" @default.
- W4295772806 doi "https://doi.org/10.1002/uog.25810" @default.
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