title: A discrepancy between gestational age estimated by last menstrual period and biparietal diameter may indicate an increased risk of fetal death and adverse pregnancy outcome.
abstract: OBJECTIVE
  To determine if the discrepancy between gestational age estimated by last menstrual period and by biparietal diameter (GALMP - GABPD) is associated with adverse pregnancy outcome.
  
  
  METHODS
  Population-based follow up study.
  
  
  METHODS
  Singleton pregnancies were studied when a reliable date of last menstrual period and biparietal diameter measured between 12 and 22 weeks of gestation was available (n = 16,469).
  
  
  METHODS
  Logistic regression analysis and Kaplan-Meier survival analysis were used to analyse the association between GALMP - GABPD and adverse pregnancy outcome.
  
  
  METHODS
  Adverse outcome was defined as abortion after 12 weeks of gestation, still-birth or postnatal death within one year of birth, delivery < 37 weeks of gestation, a birthweight < 2,500 g or a sex-specific birthweight lower than 22% below the expected.
  
  
  RESULTS
  The risk of death was more than doubled if GALMP - GABPD of > or = 8 days was compared with GALMP - GABPD of < 8 days (OR 2.2; 95% CI 1.6-3.1). The risk of death was a factor of 6.1 higher if GALMP - GABPD of > or = 8 days was combined with increased (> 2 x multiple of median) maternal alpha-fetoprotein measured in the 2nd trimester.
  
  
  CONCLUSIONS
  A discrepancy between GALMP and GABPD generally reflects the precision of the two methods used to predict term pregnancy. However, a positive discrepancy of more than seven days, particularly with high maternal alpha-fetoprotein, might indicate intrauterine growth retardation and an increased risk of adverse perinatal outcome.
authors.affiliation: Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Nguyen
authors.forename: T
authors.initials: T
authors.lastname: Larsen
authors.forename: G
authors.initials: G
authors.lastname: Engholm
authors.forename: H
authors.initials: H
authors.lastname: Møller
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005317:Fetal Growth Retardation / Q000209:etiology*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008598:Menstruation / Q000502:physiology; D010294:Parietal Bone / Q000196:embryology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins