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.
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.
Nguyen
T
T
Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
Larsen
T
T
Engholm
G
G
Møller
H
H
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
D000509:alpha-Fetoproteins