title: Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study.
abstract: OBJECTIVE
  To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates.
  
  
  METHODS
  A cohort study of 8,551 singleton pregnancies with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1st trimester), BPD (2nd trimester), and head circumference and compared mean and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods.
  
  
  RESULTS
  The change from use of second to first trimester measurements for dating was associated with a significant increase in the rate of post-term deliveries from 2.1-2.9% and a significant decrease in the rate of pre-term deliveries from 5.4-4.6% caused by systematic discrepancies. Thereby 25.1% would pass 41 weeks when GA is defined by CRL and 17.3% when BPD (2nd trimester) is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1-1.4%, when first compared to second trimester dating was used.
  
  
  CONCLUSIONS
  Systematic discrepancies were identified when biometric formulas were used to determine duration of pregnancy. This should be corrected in clinical practice to avoid an overestimation of post-term birth and unnecessary inductions when first trimester formulas are used.
authors.affiliation: Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Holbæk, Denmark.
authors.forename: Ida
authors.initials: I
authors.lastname: Näslund Thagaard
authors.affiliation: Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Holbæk, Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Krebs
authors.affiliation: Department of Paediatrics, The Children's Obesity Clinic, Copenhagen University Hospital, Holbæk, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Lausten-Thomsen
authors.affiliation: Department of Clinical Biochemistry, State Serum Institute, Copenhagen, Denmark.
authors.forename: Severin
authors.initials: S
authors.lastname: Olesen Larsen
authors.affiliation: Department of Paediatrics, The Children's Obesity Clinic, Copenhagen University Hospital, Holbæk, Denmark.
authors.forename: Jens-Christian
authors.initials: JC
authors.lastname: Holm
authors.affiliation: Department of Clinical Biochemistry, State Serum Institute, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Christiansen
authors.affiliation: Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Holbæk, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Larsen
mesh_terms: D001723:Birth Rate; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011273:Pregnancy, Prolonged