title: Combined analysis with amniotic fluid index and estimated fetal weight for prediction of severe macrosomia at birth.
abstract: OBJECTIVE
  To evaluate combined analysis with amniotic fluid index (AFI) and estimated fetal weight (EFW) for prediction of severe macrosomia at birth.
  
  
  METHODS
  In this retrospective case-control study, 50 term severe macrosomic newborns (birthweight [BW] > or = 97th percentile) were included in the study group and 100 appropriate for gestational age newborns served as controls. All pregnancies underwent a third-trimester sonographic evaluation in which AFI and EFW were measured. The association between BW and AFI and EFW percentiles was examined. The statistical analysis included Student t test, simple regression and receiver-operating curve analyses, and 2x2 tables.
  
  
  RESULTS
  The mean mid-third-trimester AFI percentile and EFW percentile in severe macrosomic infants were 72.4 +/- 22.5 and 83 +/- 12, respectively, which was significantly higher than in controls (P < .0001). Significant correlations were detected between BW and AFI and EFW percentiles (r = 0.44 and r = 0.72, respectively; P < .0001). Receiver-operating characteristic analysis identified AFI > or = 60th percentile and EFW > or = 71st percentile as best predictors of severe macrosomia. The combined analysis with AFI > or = 60th percentile and EFW > or = 71st percentile resulted in a positive predictive value of 85%.
  
  
  CONCLUSIONS
  There is a significant correlation between mid-third-trimester AFI and BW. AFI > or = 60th percentile and EFW > or = 71st percentile during the mid third trimester are useful predictors of severe macrosomia at birth.
authors.affiliation: Department of Obstetrics and Gynecology, Lenox Hill Hospital, New York, NY 10025, USA. rinatia@netvision.net.il
authors.forename: Rinat
authors.initials: R
authors.lastname: Hackmon
authors.forename: Eran
authors.initials: E
authors.lastname: Bornstein
authors.forename: Asaf
authors.initials: A
authors.lastname: Ferber
authors.forename: Javine
authors.initials: J
authors.lastname: Horani
authors.forename: Christopher P
authors.initials: CP
authors.lastname: O'Reilly Green
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Divon
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis* / Q000453:epidemiology; D020567:Fetal Weight; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal