title: Fetal thigh and upper-arm volumes by three-dimensional ultrasound to predict low postnatal body mass index.
abstract: OBJECTIVE
  To assess the usefulness of estimating fetal upper arm and thigh volumes as predictors of low postnatal body mass index (BMI) using three-dimensional ultrasonography (3DUS) with extended imaging virtual organ computer-aided analysis (XI VOCAL).
  
  
  METHODS
  This prospective cross-sectional study analyzed 300 singleton pregnancies between 33 and 41 weeks of gestation. The Hadlock 4 formula was used to estimate fetal weight. The XI VOCAL 10 planes method was used to assess fetal upper arm and thigh volumes. After delivery, the newborns' BMI was evaluated and considered low (≤10th percentile) or normal (>10th percentile). We determined receiver operating characteristics (ROC) curves and respective areas under the curves for the percentiles of fetal weight and fetal thigh and upper arm volumes.
  
  
  RESULTS
  Of the 300 newborns, BMI was ≤10th percentile for 21 and >10th percentile for 279 newborns. The area under the ROC curve for fetal weight, obtained using the Hadlock formula, and fetal upper arm and thigh volumes, obtained by 3DUS, were 0.801, 0.930 and 0.924, respectively. We determined the sensitivity and specificity of the three parameters for predicting low postnatal BMI and found values of 85.70% and 65.60%, respectively, for fetal weight, 90.48% and 88.17%, respectively, for fetal thigh volume, and 76.19% and 92.47%, respectively, for fetal upper arm volume.
  
  
  CONCLUSIONS
  Fetal upper arm and thigh volumes estimated using 3DUS with XI VOCAL were effective predictors of low postnatal BMI.
authors.affiliation: Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) , São Paulo-SP , Brazil and.
authors.forename: Rafael Oliveira
authors.initials: RO
authors.lastname: Cavalcante
authors.forename: Ana Carolina Rabachini
authors.initials: AC
authors.lastname: Caetano
authors.forename: Daniela Cristina
authors.initials: DC
authors.lastname: Nacaratto
authors.forename: Talita Micheletti
authors.initials: TM
authors.lastname: Helfer
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.forename: Luciano Marcondes Machado
authors.initials: LM
authors.lastname: Nardozza
authors.forename: Antonio Fernandes
authors.initials: AF
authors.lastname: Moron
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
mesh_terms: D000328:Adult; D000465:Algorithms; D001132:Arm / Q000000981:diagnostic imaging; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D013848:Thigh / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
keywords: Body mass index; XI VOCAL; fetus; newborn; thigh; three-dimensional ultrasound; upper-arm