Predicting late-onset growth abnormalities using growth velocity between trimesters.
OBJECTIVE
To determine whether growth velocity parameters derived from routine prenatal ultrasound measurements at first, second and third trimester can identify normal growth at term as well as late-onset growth abnormalities.


METHODS
Longitudinal study of fetal growth in normal singleton pregnancies with three normal ultrasound examinations and delivered at term. Fetuses were classified into 3 groups (<10th percentile, 10-90th percentile, >90th percentile) based on birth weight. Multiple regression on birth weight classification was used to build up a prediction equation of fetal growth potential (FGP) based on fetal biometry and fetal growth velocity parameters between ultrasound examinations. Best cut-off value for FGP predicting growth restriction and macrosomia were defined.


RESULTS
356 pregnancies were included. Fetal biometry growth velocities between examinations were calculated for all measurements. Using best cut-off values, the estimated sensitivity, specificity and odds ratio were: 60% [44;74], 91% [89;92] and 14.55 [6.30;33.98] and 53% [36;69], 89% [88;91] and 10 [4.27;23.49] for the prediction of growth restriction and macrosomia, respectively.


CONCLUSIONS
Fetal growth potential can be derived and calculated from standard ultrasound measurements. It can improve identification of these fetuses at risk for late-onset growth abnormalities and their related morbidity.
Salomon
L J
LJ
Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal de Poissy-St Germain, Poissy, France.
Bernard
J P
JP
Duyme
M
M
Ville
Y
Y
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D011237:Predictive Value of Tests; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal