title: Personalized third-trimester fetal growth evaluation: comparisons of individualized growth assessment, percentile line and conditional probability methods.
abstract: OBJECTIVE
  To compare third-trimester size trajectory prediction errors (average transformed percent deviations) for three individualized fetal growth assessment methods.
  
  
  METHODS
  This study utilized longitudinal measurements of nine directly measured size parameters in 118 fetuses with normal neonatal growth outcomes. Expected value (EV) function coefficients and variance components were obtained using two-level random coefficient modeling. Growth models (IGA) or EV coefficients and variance components (PLM and CPM) were used to calculate predicted values at ∼400 third-trimester time points. Percent deviations (%Dev) calculated at these time points using all three methods were expressed as percentages of IGA MA-specific reference ranges [transformed percent deviations (T%Dev)]. Third-trimester T%Dev values were averaged (aT%Dev) for each parameter. Mean ± standard deviation's for sets of aT%Dev values derived from each method (IGA, PLM and CPM) were calculated and compared.
  
  
  RESULTS
  Mean aT%Dev values for nine parameters were: (i) IGA: -4.3 to 5.2% (9/9 not different from zero); (ii) PLM: -32.7 to 25.6% (4/9 not different from zero) and (iii) CPM: -20.4 to 17.4% (5/9 not different from zero). Seven of nine systematic deviations from zero were statistically significant when IGA values were compared to either PLM or CPM values. Variabilities were smaller for IGA when compared to those for PLM or CPM, with (i) 5/9 being statistically significant (IGA versus PLM), (ii) 2/9 being statistically significant (IGA versus CPM) and (iii) 5/9 being statistically significant (PLM versus CPM).
  
  
  CONCLUSIONS
  Significant differences in the agreement between predicted third-trimester size parameters and their measured values were found for the three methods tested. With most parameters, IGA gave smaller mean aT%Dev values and smaller variabilities. The CPM method was better than the PLM approach for most but not all parameters. These results suggest that third-trimester size trajectories are best characterized by IGA in fetuses with normal growth outcomes.
authors.affiliation: a Department of Obstetrics and Gynecology , Baylor College of Medicine , Houston , TX , USA .
authors.forename: Russell L
authors.initials: RL
authors.lastname: Deter
authors.affiliation: a Department of Obstetrics and Gynecology , Baylor College of Medicine , Houston , TX , USA .|b Department of Obstetrics and Gynecology , Oakland University William Beaumont School of Medicine , Rochester , MI , USA .|c Perinatology Research Branch, NICHD/NIH/DHHS , Detroit , MI , USA .
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
authors.affiliation: a Department of Obstetrics and Gynecology , Baylor College of Medicine , Houston , TX , USA .
authors.forename: Haleh
authors.initials: H
authors.lastname: Sangi-Haghpeykar
authors.affiliation: c Perinatology Research Branch, NICHD/NIH/DHHS , Detroit , MI , USA .
authors.forename: Adi L
authors.initials: AL
authors.lastname: Tarca
authors.affiliation: d Department of Electrical and Computer Engineering , Oakland University , Rochester , MI , USA .
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: c Perinatology Research Branch, NICHD/NIH/DHHS , Detroit , MI , USA .|e Department of Obstetrics and Gynecology , Wayne State University/Hutzel Hospital , Detroit , MI , USA .
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.affiliation: c Perinatology Research Branch, NICHD/NIH/DHHS , Detroit , MI , USA .|f Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA , and.|g Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
mesh_terms: D005260:Female; D047109:Fetal Development; D006801:Humans; D008137:Longitudinal Studies; D015233:Models, Statistical; D057285:Precision Medicine / Q000379:methods; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal / Q000379:methods / Q000706:statistics & numerical data*
keywords: Fetal size trajectories; Rossavik size model; ultrasound