A routine third trimester growth ultrasound in the obese pregnant woman does not reliably identify fetal growth abnormalities: A retrospective cohort study

AbstractTo investigate the value of the birth weight of the previous pregnancy (BWSome 1298 parous women with uncomplicated singleton pregnancies who had a third trimester ultrasound scan were considered as samples in this retrospective cohort study. Maternal and pregnancy characteristics, BWBW: BW

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Accuracy of Prenatal Ultrasound in Detecting Growth Abnormalities in Triplets: A Retrospective Cohort Study

Twin Research and Human Genetics ◽

10.1017/thg.2016.92 ◽

2017 ◽

Vol 20 (1) ◽

pp. 84-89 ◽

Cited By ~ 3

Author(s):

Cameron Sklar ◽

Maryna Yaskina ◽

Sue Ross ◽

Kentia Naud

Keyword(s):

Cohort Study ◽

Fetal Growth ◽

Retrospective Cohort Study ◽

Predictive Value ◽

Retrospective Cohort ◽

Prenatal Ultrasound ◽

Growth Restriction ◽

Fetal Weight ◽

Growth Abnormalities ◽

Estimated Fetal Weight

Significant management decisions in triplet pregnancies are made based mainly on ultrasound measurements of fetal growth, although there is a paucity of data examining the accuracy of fetal weight measurements in these gestations. To evaluate accuracy of prenatal ultrasound to diagnose growth abnormalities (intrauterine growth restriction, severe growth discordance) in triplet pregnancies, a retrospective cohort study of 78 triplet pregnancies (234 fetuses) delivered at a single tertiary hospital from January 2004 to May 2015 was performed. Growth percentiles from the last ultrasound were derived from estimated fetal weight using Hadlock's formula for each triplet. Growth discordance was calculated for each triplet set using the formula {(estimated fetal weight largest triplet - estimated fetal weight smallest)/estimated fetal weight largest}. These estimations were compared to birth weights. Sensitivity of ultrasound to predict ≥1 growth restricted fetus in a triplet set was 55.6% [95% CI 35.3, 74.5]; specificity was 100% [95% CI 93.0, 100]; positive predictive value (PPV) 100% [95% CI 74.7, 100]; negative predictive value (NPV) 81.0% [95% CI 73.2, 85.7%]. Sensitivity of ultrasound to detect fetal growth discordance >25% in a triplet set was 80.0% [95% CI 44.4, 97.5], specificity 94.1% [95% CI 85.6, 98.4]; PPV 66.7% [95% CI 42.4, 84.5]; NPV 97.0% [95% CI 90.2, 99.1]. Prenatal ultrasound currently remains the most reliable tool to screen for growth anomalies in triplet pregnancies; however, it appears to have less than ideal sensitivity, missing a number of cases of intra-uterine growth restriction and significant growth discordance.

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Comparison of logistic regression with machine learning methods for the prediction of fetal growth abnormalities: a retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-018-1971-2 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 12

Author(s):

Stefan Kuhle ◽

Bryan Maguire ◽

Hongqun Zhang ◽

David Hamilton ◽

Alexander C. Allen ◽

...

Keyword(s):

Machine Learning ◽

Logistic Regression ◽

Cohort Study ◽

Fetal Growth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Learning Methods ◽

Machine Learning Methods ◽

Growth Abnormalities

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“INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

10.21203/rs.2.15293/v1 ◽

2019 ◽

Author(s):

Juan Jesus Fernández Alba ◽

Estefania Soto Pazos ◽

Rocio Moreno Cortes ◽

Angel Vilar Sanchez ◽

Carmen Gonzalez Macias ◽

...

Keyword(s):

Cohort Study ◽

Gestational Diabetes ◽

Nutritional Status ◽

Positive Predictive Value ◽

Pregnant Women ◽

Fetal Growth ◽

Retrospective Cohort Study ◽

Predictive Value ◽

Retrospective Cohort ◽

Growth Curves

Abstract Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polihydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to limit fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWT21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st.(RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).Conclusions In pregnant women with GDM, the ability of customized fetal growth curves to identify the newborns with alterations in nutritional status exceeds that of INTERGROWTH21st.

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The prevalence of brain lesions after in utero surgery for twin-to-twin transfusion syndrome on third-trimester MRI: a retrospective cohort study

European Radiology ◽

10.1007/s00330-020-07452-x ◽

2020 ◽

Author(s):

Michael Aertsen ◽

Caroline Van Tieghem De Ten Berghe ◽

Sanne Deneckere ◽

Isabel Couck ◽

Luc De Catte ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

In Utero ◽

Brain Lesions ◽

Third Trimester

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Perinatal Outcomes of Monochorionic-Diamniotic Twin Pregnancies Uncomplicated at 28 Weeks of Gestation

Japanese Clinical Medicine ◽

10.4137/jcm.s38895 ◽

2016 ◽

Vol 7 ◽

pp. JCM.S38895 ◽

Cited By ~ 3

Author(s):

Shunji Suzuki

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Second Trimester ◽

Perinatal Complications ◽

Third Trimester ◽

The Third ◽

Perinatal Center ◽

Twin Pregnancies

We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy. Two cases were complicated by twin–twin transfusion syndrome, two cases were complicated by twin anemia–polycythemia sequence, and one case was complicated by acute twin–twin transfusion syndrome. In the five cases, no abnormal ultrasonographic findings or symptoms were recognized one or two weeks prior to the diagnosis. Fifty-eight cases (65.9%) were delivered at term uneventfully. Serious complications due to placental circulatory imbalance between twins occurred in about 6% of cases during the third trimester of pregnancy.

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The effect of maternal antidepressants on third trimester uteroplacental hemodynamics and the neonatal abstinence syndrome: a retrospective cohort study

Archives of Women s Mental Health ◽

10.1007/s00737-019-00954-8 ◽

2019 ◽

Vol 22 (6) ◽

pp. 791-797 ◽

Cited By ~ 1

Author(s):

Katherine McLean ◽

Kellie E. Murphy ◽

Ariel Dalfen ◽

Alison K. Shea

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Third Trimester

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INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes

10.21203/rs.2.15293/v3 ◽

2020 ◽

Author(s):

Juan Jesus Fernández Alba ◽

Estefania Soto Pazos ◽

Rocio Moreno Cortes ◽

Angel Vilar Sanchez ◽

Carmen Gonzalez Macias ◽

...

Keyword(s):

Cohort Study ◽

Gestational Diabetes ◽

Nutritional Status ◽

Positive Predictive Value ◽

Pregnant Women ◽

Fetal Growth ◽

Retrospective Cohort Study ◽

Predictive Value ◽

Retrospective Cohort ◽

Growth Curves

Abstract Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polyhydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to assess for fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers. Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. The nutritional status of newborns was assessed using the ponderal index . Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios. Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWTH21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st. (RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%). Conclusions In pregnant women with DMG, the ability of customized fetal growth curves to identify newborns with alterations in nutritional status appears to exceed that of INTERGROWTH21st

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Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies—A Single-Center Retrospective Cohort Study

Children ◽

10.3390/children8060522 ◽

2021 ◽

Vol 8 (6) ◽

pp. 522

Author(s):

Anna Kajdy ◽

Stepan Feduniw ◽

Jan Modzelewski ◽

Dorota Sys ◽

Dagmara Filipecka-Tyczka ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Neonatal Death ◽

Retrospective Cohort ◽

Neonatal Outcome ◽

Growth Restriction ◽

Chronic Hypertension ◽

Single Center ◽

Growth Abnormalities

(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.

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