Prediction of small for gestational age by logistic regression in twins.
BACKGROUND
Small for gestational age (SGA) is one of the major determinants of perinatal mortality and morbidity, and may relate in adult diseases. Early prediction of SGA could be helpful for health care providers and public health workers in guiding antenatal management and prevention. The reported methods of SGA prediction are not satisfactory because the diagnostic performance is poor and the interval between prediction and delivery is too short.


OBJECTIVE
To establish a SGA prediction model for twin pregnancies based on variables obtainable in early gestation.


METHODS
We used a large twin registry United States data (1995-1997). The study subjects were randomly divided into two groups: group 1 to establish the prediction model by logistic regression and group 2 to validate the prediction model. SGA was defined as birth weight for gestational age z scores less than 10th percentiles. Pair of twin was the unit of analysis. Two sets of multiple logistic regression analyses with different outcome measures - one or both twins SGAs and both twins SGAs - were used to establish the prediction model.


RESULTS
The sensitivity, specificity, and positive predictive value were 52.3, 62.5, and 21.5%, respectively, at the cutoff value 0.16 in a SGA prediction model based on maternal race, education, marital status, parity, prenatal care visit initiation, cigarette smoking, and paternal race.


CONCLUSIONS
A prediction model based on determinants that can be obtained at early gestation might be useful in the management of pregnancies with high risk of SGA in twins.
Wen
Shi Wu
SW
School of Public Health, Central South University, Changsha, China. swwen@ohri.ca
Tan
Hongzhuan
H
Yang
Qiuying
Q
Walker
Mark
M
D000328:Adult; D015331:Cohort Studies; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D009864:Ontario / Q000453:epidemiology; D010331:Paternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014427:Twins