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Defining fetal growth restriction: abdominal circumference as an alternative criterion

Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA). Materials and methods: All non-anomalous singletons undergoing ultras...

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Published in:	The journal of maternal-fetal & neonatal medicine 2018-12, Vol.31 (23), p.3089-3094
Main Authors:	Rad, Steve, Beauchamp, S., Morales, C., Mirocha, J., Esakoff, T. F.
Format:	Article
Language:	English
Subjects:	Adult Case-Control Studies Estimated fetal weight Female fetal abdominal circumference Fetal Growth Retardation - diagnosis Fetal Growth Retardation - diagnostic imaging fetal intrauterine growth restriction fetal ultrasound Fetal Weight Gestational Age Humans Infant, Small for Gestational Age Predictive Value of Tests Pregnancy Retrospective Studies ROC Curve small for gestational age Ultrasonography, Prenatal - statistics & numerical data Waist Circumference
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container_title	The journal of maternal-fetal & neonatal medicine
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creator	Rad, Steve Beauchamp, S. Morales, C. Mirocha, J. Esakoff, T. F.
description	Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA). Materials and methods: All non-anomalous singletons undergoing ultrasound at a single center at ≥36 weeks during 12/2008-5/2014 were included. FGR was defined as (estimated fetal weight) estimated fetal weight (EFW) and/or abdominal circumference (AC)
doi_str_mv	10.1080/14767058.2017.1364723
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F.</creator><creatorcontrib>Rad, Steve ; Beauchamp, S. ; Morales, C. ; Mirocha, J. ; Esakoff, T. F.</creatorcontrib><description><![CDATA[Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA). Materials and methods: All non-anomalous singletons undergoing ultrasound at a single center at ≥36 weeks during 12/2008-5/2014 were included. FGR was defined as (estimated fetal weight) estimated fetal weight (EFW) and/or abdominal circumference (AC) < 10 for gestational age (GA). The primary outcome was SGA (birthweight ≤10th percentile for GA). Data were stratified by maternal race/ethnicity and BMI. Sensitivity, specificity, false-positive rate (FPR), positive- and negative-predictive values (positive-predictive value (PPV), negative-predictive value (NPV)), and areas under the receiver-operating characteristic (ROC) curve (AUC were calculated. Results: There were 1594 ultrasounds. Median (IQR) ultrasound GA was 37.3 (36.6-38.0), days to delivery 10.6 (5.0-18.4), and delivery GA 39.29 (38.6-39.9). EFW <10 had the following characteristics: sensitivity 50.6%, FPR 2.0%, PPV 83.8%, and AUC 0.743. Using AC <10, these were 64.0, 2.9, 81.3, and 0.806, respectively. Using AC or EFW <10, these were 67.5, 3.3, 80.3, and 0.821, respectively; this criterion has the largest AUC (p < .008). This finding persisted when stratified by maternal race/ethnicity and BMI. Conclusions: AC <10 is more sensitive and has a similar PPV compared with EFW <10 for SGA. Using AC <10 or EFW <10 has the best balance of sensitivity and specificity as a screening test and has a low FPR. AC may be a reasonable alternative criterion to EFW for FGR diagnosis.]]></description><identifier>ISSN: 1476-7058</identifier><identifier>EISSN: 1476-4954</identifier><identifier>DOI: 10.1080/14767058.2017.1364723</identifier><identifier>PMID: 28817998</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adult ; Case-Control Studies ; Estimated fetal weight ; Female ; fetal abdominal circumference ; Fetal Growth Retardation - diagnosis ; Fetal Growth Retardation - diagnostic imaging ; fetal intrauterine growth restriction ; fetal ultrasound ; Fetal Weight ; Gestational Age ; Humans ; Infant, Small for Gestational Age ; Predictive Value of Tests ; Pregnancy ; Retrospective Studies ; ROC Curve ; small for gestational age ; Ultrasonography, Prenatal - statistics & numerical data ; Waist Circumference</subject><ispartof>The journal of maternal-fetal & neonatal medicine, 2018-12, Vol.31 (23), p.3089-3094</ispartof><rights>2017 Informa UK Limited, trading as Taylor & Francis Group 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-d4c5b675a6d9b514eb20b289ac132da5ea7b2bbd9e534205b2fd5843a525e8ae3</citedby><cites>FETCH-LOGICAL-c366t-d4c5b675a6d9b514eb20b289ac132da5ea7b2bbd9e534205b2fd5843a525e8ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28817998$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rad, Steve</creatorcontrib><creatorcontrib>Beauchamp, S.</creatorcontrib><creatorcontrib>Morales, C.</creatorcontrib><creatorcontrib>Mirocha, J.</creatorcontrib><creatorcontrib>Esakoff, T. F.</creatorcontrib><title>Defining fetal growth restriction: abdominal circumference as an alternative criterion</title><title>The journal of maternal-fetal & neonatal medicine</title><addtitle>J Matern Fetal Neonatal Med</addtitle><description><![CDATA[Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA). Materials and methods: All non-anomalous singletons undergoing ultrasound at a single center at ≥36 weeks during 12/2008-5/2014 were included. FGR was defined as (estimated fetal weight) estimated fetal weight (EFW) and/or abdominal circumference (AC) < 10 for gestational age (GA). The primary outcome was SGA (birthweight ≤10th percentile for GA). Data were stratified by maternal race/ethnicity and BMI. Sensitivity, specificity, false-positive rate (FPR), positive- and negative-predictive values (positive-predictive value (PPV), negative-predictive value (NPV)), and areas under the receiver-operating characteristic (ROC) curve (AUC were calculated. Results: There were 1594 ultrasounds. Median (IQR) ultrasound GA was 37.3 (36.6-38.0), days to delivery 10.6 (5.0-18.4), and delivery GA 39.29 (38.6-39.9). EFW <10 had the following characteristics: sensitivity 50.6%, FPR 2.0%, PPV 83.8%, and AUC 0.743. Using AC <10, these were 64.0, 2.9, 81.3, and 0.806, respectively. Using AC or EFW <10, these were 67.5, 3.3, 80.3, and 0.821, respectively; this criterion has the largest AUC (p < .008). This finding persisted when stratified by maternal race/ethnicity and BMI. Conclusions: AC <10 is more sensitive and has a similar PPV compared with EFW <10 for SGA. Using AC <10 or EFW <10 has the best balance of sensitivity and specificity as a screening test and has a low FPR. AC may be a reasonable alternative criterion to EFW for FGR diagnosis.]]></description><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Estimated fetal weight</subject><subject>Female</subject><subject>fetal abdominal circumference</subject><subject>Fetal Growth Retardation - diagnosis</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>fetal intrauterine growth restriction</subject><subject>fetal ultrasound</subject><subject>Fetal Weight</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant, Small for Gestational Age</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>small for gestational age</subject><subject>Ultrasonography, Prenatal - statistics & numerical data</subject><subject>Waist Circumference</subject><issn>1476-7058</issn><issn>1476-4954</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0E4lH4BFCWbFr8TBxWIN4SEhtga42dCRglNtgpVf-eVC0sWdkenzszOoQcMzpjVNMzJquyokrPOGXVjIlSVlxskf1VfSprJbc39xW0Rw5y_qCUM0nVLtnjWrOqrvU-eb3G1gcf3ooWB-iKtxQXw3uRMA_Ju8HHcF6AbWLvw_jrfHLzvsWEwWEBuYBQQDdgCjD4byxc8uNjDB2SnRa6jEebc0Jebm-er-6nj093D1eXj1MnynKYNtIpW1YKyqa2ikm0nFqua3BM8AYUQmW5tU2NSkhOleVto7QUoLhCDSgm5HTd9zPFr_m4tOl9dth1EDDOs2G1oLLStKxHVK1Rl2LOCVvzmXwPaWkYNSul5lepWSk1G6Vj7mQzYm57bP5Svw5H4GIN-NDG1MMipq4xAyy7mNoEwflsxP8zfgArlocO</recordid><startdate>20181202</startdate><enddate>20181202</enddate><creator>Rad, Steve</creator><creator>Beauchamp, S.</creator><creator>Morales, C.</creator><creator>Mirocha, J.</creator><creator>Esakoff, T. F.</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20181202</creationdate><title>Defining fetal growth restriction: abdominal circumference as an alternative criterion</title><author>Rad, Steve ; Beauchamp, S. ; Morales, C. ; Mirocha, J. ; Esakoff, T. F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-d4c5b675a6d9b514eb20b289ac132da5ea7b2bbd9e534205b2fd5843a525e8ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Estimated fetal weight</topic><topic>Female</topic><topic>fetal abdominal circumference</topic><topic>Fetal Growth Retardation - diagnosis</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>fetal intrauterine growth restriction</topic><topic>fetal ultrasound</topic><topic>Fetal Weight</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant, Small for Gestational Age</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>small for gestational age</topic><topic>Ultrasonography, Prenatal - statistics & numerical data</topic><topic>Waist Circumference</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rad, Steve</creatorcontrib><creatorcontrib>Beauchamp, S.</creatorcontrib><creatorcontrib>Morales, C.</creatorcontrib><creatorcontrib>Mirocha, J.</creatorcontrib><creatorcontrib>Esakoff, T. F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rad, Steve</au><au>Beauchamp, S.</au><au>Morales, C.</au><au>Mirocha, J.</au><au>Esakoff, T. F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defining fetal growth restriction: abdominal circumference as an alternative criterion</atitle><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle><addtitle>J Matern Fetal Neonatal Med</addtitle><date>2018-12-02</date><risdate>2018</risdate><volume>31</volume><issue>23</issue><spage>3089</spage><epage>3094</epage><pages>3089-3094</pages><issn>1476-7058</issn><eissn>1476-4954</eissn><abstract><![CDATA[Purpose: The purpose of this study is to determine if using abdominal circumference percentile (AC) to define fetal growth restriction (FGR) improves ultrasound at ≥36 weeks as a screening test for small for gestational age (SGA). Materials and methods: All non-anomalous singletons undergoing ultrasound at a single center at ≥36 weeks during 12/2008-5/2014 were included. FGR was defined as (estimated fetal weight) estimated fetal weight (EFW) and/or abdominal circumference (AC) < 10 for gestational age (GA). The primary outcome was SGA (birthweight ≤10th percentile for GA). Data were stratified by maternal race/ethnicity and BMI. Sensitivity, specificity, false-positive rate (FPR), positive- and negative-predictive values (positive-predictive value (PPV), negative-predictive value (NPV)), and areas under the receiver-operating characteristic (ROC) curve (AUC were calculated. Results: There were 1594 ultrasounds. Median (IQR) ultrasound GA was 37.3 (36.6-38.0), days to delivery 10.6 (5.0-18.4), and delivery GA 39.29 (38.6-39.9). EFW <10 had the following characteristics: sensitivity 50.6%, FPR 2.0%, PPV 83.8%, and AUC 0.743. Using AC <10, these were 64.0, 2.9, 81.3, and 0.806, respectively. Using AC or EFW <10, these were 67.5, 3.3, 80.3, and 0.821, respectively; this criterion has the largest AUC (p < .008). This finding persisted when stratified by maternal race/ethnicity and BMI. Conclusions: AC <10 is more sensitive and has a similar PPV compared with EFW <10 for SGA. Using AC <10 or EFW <10 has the best balance of sensitivity and specificity as a screening test and has a low FPR. AC may be a reasonable alternative criterion to EFW for FGR diagnosis.]]></abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>28817998</pmid><doi>10.1080/14767058.2017.1364723</doi><tpages>6</tpages></addata></record>
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subjects	Adult Case-Control Studies Estimated fetal weight Female fetal abdominal circumference Fetal Growth Retardation - diagnosis Fetal Growth Retardation - diagnostic imaging fetal intrauterine growth restriction fetal ultrasound Fetal Weight Gestational Age Humans Infant, Small for Gestational Age Predictive Value of Tests Pregnancy Retrospective Studies ROC Curve small for gestational age Ultrasonography, Prenatal - statistics & numerical data Waist Circumference
title	Defining fetal growth restriction: abdominal circumference as an alternative criterion
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