Detecting fetal macrosomia with abdominal circumference alone.

Henrichs C, Magann EF, Brantley KL, Crews JH, Sanderson M, Chauhan SP
J Reprod Med. 2003 48 (5): 339-42

PMID: 12815906

OBJECTIVE - To determine if abdominal circumference (AC) can identify macrosomia (> or = 4,000 g) at or beyond 37 weeks.

STUDY DESIGN - Prospectively, parturients at term admitted for delivery underwent sonographic mensuration of AC. A receiver-operating characteristic (ROC) curve was constructed to determine if AC can differentiate between normal (birth weight < 3,999 g) and macrosomia. A likelihood ratio was calculated. P < .05 was considered significant.

RESULTS - The mean gestational age of the 256 subjects was 39.1 +/- 1.5 weeks, and the prevalence of macrosomia was 8.2% (21/256). Inspection of the ROC curve indicated that AC > or = 350 mm can identify macrosomic fetuses. The area under the ROC curve (0.79 +/- 0.04 for macrosomia) was significantly different than the area under the nondiagnostic line (P < .005). The likelihood ratio for AC to detect macrosomia was 2.9 (95% confidence interval, 2.1-4.0). Based on the proportion of macrosomia in our population, we would require over 1,000,000 newborns for a macrosomia analysis to obtain narrow confidence intervals around a clinically useful likelihood ratio.

CONCLUSION - Using the guidelines proposed by the Evidence-Based Medicine Working Group, AC is slightly useful in detecting macrosomia among term parturients.

MeSH Terms (12)

Abdomen Adolescent Adult Anthropometry Female Fetal Macrosomia Gestational Age Humans Pregnancy Prospective Studies Sensitivity and Specificity Ultrasonography, Prenatal

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