First-trimester prediction of macrosomia.
OBJECTIVE
To determine if combinations of maternal characteristics and measurements of parameters used in screening for aneuploidies at 11-13 weeks provide significant prediction of macrosomia.


METHODS
Maternal characteristics, fetal nuchal translucency (NT), free β-human chorionic gonadotrophin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) were recorded at 11(+0)-13(+6) weeks in 36,743 singleton pregnancies. Regression analysis was used to determine if in predicting macrosomia significant contributions are provided by maternal factors, fetal NT, free β-hCG and PAPP-A.


RESULTS
The risk for macrosomia increased with maternal weight and height and was higher in parous women with previous delivery of a macrosomic baby and in those with diabetes mellitus; the risk was lower in women of African and South Asian racial origins, in cigarette smokers and in those with chronic hypertension. In the macrosomic group compared to the unaffected group there were higher Δ-NT (0.167 vs. 0.116 mm), free β-hCG (1.010 vs. 0.964 MoM) and PAPP-A (1.103 vs. 1.003 MoM). Prediction of macrosomia provided by maternal factors was significantly improved by fetal NT, free β-hCG and PAPP-A (34.4 vs. 33.1% at a false-positive rate of 10%).


CONCLUSIONS
Prediction of macrosomia is provided in the first trimester of pregnancy by a combination of maternal characteristics and measurements of parameters used in screening for aneuploidies.
Poon
Leona C Y
LC
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, University College Hospital, London, UK.
Karagiannis
George
G
Stratieva
Violeta
V
Syngelaki
Argyro
A
Nicolaides
Kypros H
KH
D000328:Adult; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood* / Q000000981:diagnostic imaging; D005544:Forecasting; D006801:Humans; D008403:Mass Screening; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D012044:Regression Analysis
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A