title: Accuracy of clinically estimated fetal weight in pregnancies complicated by diabetes mellitus and obesity.
abstract: OBJECTIVE
  To determine the accuracy of clinically estimated fetal weight (CEFW) in patients with gestational diabetes (GDM), pregestational diabetes (DM), and obesity.
  
  
  METHODS
  This is a retrospective analysis of Consortium of Safe Labor data. Subjects were classified into six groups: DM, DM and obese, GDM, GDM and obese, nondiabetic obese, and controls. The mean difference between birth weight (BW) and CEFW, the percent of accurate CEFW (defined as < 10% difference), and the sensitivity for identifying BW > 4,000 g and > 4,500 g were calculated for each group.
  
  
  RESULTS
  The accuracy of CEFW in our population was 54.3 to 64.4% and was significantly lower in patients with DM and obesity and patients with obesity but not diabetes. When CEFW was analyzed in the >4,000-g and > 4,500-g groups, its accuracy was 20 to 51% and 14 to 40%, respectively. CEFW overestimated BW more commonly in GDM, obese GDM, and obese groups. The sensitivity of CEFW for diagnosing BW > 4,000 g or > 4,500 g was 19.6% and 9.6%, respectively, and it improved in pregnancies complicated by diabetes.
  
  
  CONCLUSIONS
  CEFW is a poor predictor of macrosomia in pregnancies complicated by obesity and diabetes.
authors: Department of Obstetrics and Gynecology, Georgetown University Hospital, MedStar Health, Washington, District of Columbia.
authors: Daphnie
authors: D
authors: Drassinower
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington Hospital Center, MedStar Health, Washington, District of Columbia.
authors: Julia
authors: J
authors: Timofeev
authors: Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland.
authors: Chun-Chih
authors: CC
authors: Huang
authors: Department of Obstetrics and Gynecology, Georgetown University Hospital, MedStar Health, Washington, District of Columbia.
authors: James E
authors: JE
authors: Benson
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington Hospital Center, MedStar Health, Washington, District of Columbia.
authors: Rita W
authors: RW
authors: Driggers
authors: Department of Obstetrics and Gynecology, Georgetown University Hospital, MedStar Health, Washington, District of Columbia.
authors: Helain J
authors: HJ
authors: Landy
mesh_terms: D000328:Adult; D001724:Birth Weight; D048909:Diabetes Complications; D016640:Diabetes, Gestational; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D020567:Fetal Weight; D006801:Humans; D009765:Obesity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D012189:Retrospective Studies; D055815:Young Adult