title: First trimester prediction of small- and large-for-gestation neonates by an integrated model incorporating ultrasound parameters, biochemical indices and maternal characteristics.
abstract: OBJECTIVE
  To identify maternal/pregnancy characteristics, first trimester ultrasound parameters and biochemical indices which are significant independent predictors of small-for-gestational age (SGA) and large-for-gestational age (LGA) neonates.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  Two fetal Medicine Units.
  
  
  METHODS
  4 702 singleton pregnancies presenting for screening for chromosomal abnormalities by nuchal translucency and maternal serum biochemistry at 11-14 weeks.
  
  
  METHODS
  Reference ranges for birthweight applied to our population were constructed by the Royston and Wright method. Multiple logistic regression was applied to develop first trimester prediction models for SGA and LGA.
  
  
  METHODS
  Birth of SGA or LGA neonate.
  
  
  RESULTS
  Maternal height, parity, smoking, assisted conception, delta crown-rump length, delta nuchal translucency, free beta human chorionic gonadotrophin and pregnancy-associated plasma protein-A were significant independent predictors of SGA. Maternal weight and height, smoking, delta crown-rump length and delta nuchal translucency were significant independent predictors of LGA. Models for SGA (AUC=0.7296, CI: 0.69-0.76, p<0.0001) and LGA (AUC=0.6901, CI: 0.65-0.72, p<0.0001) were derived, applicable to routine obstetric population at low risk for these conditions. For 20% screen positive rate the modeling achieves sensitivities of about 55% for SGA and 48% for LGA neonates.
  
  
  CONCLUSIONS
  Prediction for birthweight deviations is feasible using data available at the routine 11-14 weeks' examination. Delta CRL and delta nuchal translucency were significant independent predictors for both SGA and LGA.
authors: Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital.
authors: Ioannis
authors: I
authors: Papastefanou
authors: Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital.|Lito Maternity Hospital, Fetal Medicine Department, Athens, Greece.
authors: Athena P
authors: AP
authors: Souka
authors: Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital.|Lito Maternity Hospital, Fetal Medicine Department, Athens, Greece.
authors: Athanasios
authors: A
authors: Pilalis
authors: Lito Maternity Hospital, Fetal Medicine Department, Athens, Greece.
authors: Makarios
authors: M
authors: Eleftheriades
authors: Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital.
authors: Vasiliki
authors: V
authors: Michalitsi
authors: Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, 'Attikon' University Hospital.
authors: Demetrios
authors: D
authors: Kassanos
mesh_terms: D000293:Adolescent; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008875:Middle Aged; D008954:Models, Biological; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A