The impact of optimal dating on the assessment of fetal growth

Abstract Background The impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated. Methods Nationwide cross-sectional study of routine fetal ultrasound biometry in lo...

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Main Authors: N. Fries, F. Dhombres, M. Massoud, J. J. Stirnemann, R. Bessis, G. Haddad, L. J. Salomon
Format: Article
Language:English
Published: BMC 2021-02-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-021-03640-9
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author N. Fries
F. Dhombres
M. Massoud
J. J. Stirnemann
R. Bessis
G. Haddad
L. J. Salomon
author_facet N. Fries
F. Dhombres
M. Massoud
J. J. Stirnemann
R. Bessis
G. Haddad
L. J. Salomon
author_sort N. Fries
collection DOAJ
description Abstract Background The impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated. Methods Nationwide cross-sectional study of routine fetal ultrasound biometry in low-risk pregnant women whose gestational age (GA) had been previously assessed by a first trimester CRL measurement. We compared the CRL-based GA according to the Robinson formula and the IG formula. We evaluated the fetal biometric measurements as well as the EFW taken later in pregnancy depending on the dating formula used. Mean and standard deviation of the Z scores as well as the number and percentage of cases classified as <3rd, < 10th, >90th and > 97th percentile were compared. Results Three thousand five hundred twenty-two low-risk women with scans carried out after 18 weeks were included. There were differences of zero, one and 2 days in 642 (18.2%), 2700 (76.7%) and 180 (5%) when GA was estimated based on the Robinson or the IG formula, respectively. The biometry Z scores assessed later in pregnancy were all statistically significantly lower when the Intergrowth-based dating formula was used (p < 10− 4). Likewise, the number and percentage of foetuses classified as <3rd, < 10th, >90th and > 97th percentile demonstrated significant differences. As an example, the proportion of SGA foetuses varied from 3.46 to 4.57% (p = 0.02) and that of LGA foetuses from 17.86 to 13.4% (p < 10− 4). Conclusion The dating formula used has a quite significant impact on the subsequent evaluation of biometry and EFW. We suggest that the combined and homogeneous use of a recent dating standard, together with prescriptive growth standards established on the same low-risk pregnancies, allows an optimal assessment of fetal growth.
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spelling doaj.art-3030af28f8c24dc6af9d0d46c24000462022-12-21T22:11:15ZengBMCBMC Pregnancy and Childbirth1471-23932021-02-012111810.1186/s12884-021-03640-9The impact of optimal dating on the assessment of fetal growthN. Fries0F. Dhombres1M. Massoud2J. J. Stirnemann3R. Bessis4G. Haddad5L. J. Salomon6Collége Français d’Echographie Foetale, CFEFCollége Français d’Echographie Foetale, CFEFCollége Français d’Echographie Foetale, CFEFEA FETUS, 7328, Université Paris-DescartesCollége Français d’Echographie Foetale, CFEFCollége Français d’Echographie Foetale, CFEFCollége Français d’Echographie Foetale, CFEFAbstract Background The impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated. Methods Nationwide cross-sectional study of routine fetal ultrasound biometry in low-risk pregnant women whose gestational age (GA) had been previously assessed by a first trimester CRL measurement. We compared the CRL-based GA according to the Robinson formula and the IG formula. We evaluated the fetal biometric measurements as well as the EFW taken later in pregnancy depending on the dating formula used. Mean and standard deviation of the Z scores as well as the number and percentage of cases classified as <3rd, < 10th, >90th and > 97th percentile were compared. Results Three thousand five hundred twenty-two low-risk women with scans carried out after 18 weeks were included. There were differences of zero, one and 2 days in 642 (18.2%), 2700 (76.7%) and 180 (5%) when GA was estimated based on the Robinson or the IG formula, respectively. The biometry Z scores assessed later in pregnancy were all statistically significantly lower when the Intergrowth-based dating formula was used (p < 10− 4). Likewise, the number and percentage of foetuses classified as <3rd, < 10th, >90th and > 97th percentile demonstrated significant differences. As an example, the proportion of SGA foetuses varied from 3.46 to 4.57% (p = 0.02) and that of LGA foetuses from 17.86 to 13.4% (p < 10− 4). Conclusion The dating formula used has a quite significant impact on the subsequent evaluation of biometry and EFW. We suggest that the combined and homogeneous use of a recent dating standard, together with prescriptive growth standards established on the same low-risk pregnancies, allows an optimal assessment of fetal growth.https://doi.org/10.1186/s12884-021-03640-9FetalGrowthCRLEFWIntegrowthDating
spellingShingle N. Fries
F. Dhombres
M. Massoud
J. J. Stirnemann
R. Bessis
G. Haddad
L. J. Salomon
The impact of optimal dating on the assessment of fetal growth
BMC Pregnancy and Childbirth
Fetal
Growth
CRL
EFW
Integrowth
Dating
title The impact of optimal dating on the assessment of fetal growth
title_full The impact of optimal dating on the assessment of fetal growth
title_fullStr The impact of optimal dating on the assessment of fetal growth
title_full_unstemmed The impact of optimal dating on the assessment of fetal growth
title_short The impact of optimal dating on the assessment of fetal growth
title_sort impact of optimal dating on the assessment of fetal growth
topic Fetal
Growth
CRL
EFW
Integrowth
Dating
url https://doi.org/10.1186/s12884-021-03640-9
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