Abstract
Objective
To derive and validate a population-specific multivariate approach for birth weight (BW) prediction based on quantitative intrapartum assessment of maternal characteristics by means of an algorithmic method in low-risk women.
Methods
The derivation part (n = 200) prospectively explored 10 variables to create the best-fit algorithms (70% correct estimates within ±10% of actual BW) for prediction of BW at term; vertex presentation with engagement. The algorithm was then cross validated with samples of unrelated cases (n = 280) to compare the accuracy with the routine abdominal palpation method.
Results
The best-fit algorithms were parity-specific. The derived simplified algorithms were (1) BW (g) = 100 [(0.42 × symphysis-fundal height (SFH; cm)) + gestational age at delivery (GA; weeks) − 25] in nulliparous, and (2) BW (g) = 100 [(0.42 × SFH (cm)) + GA − 23] in multiparous. Cross validation showed an overall 69.3% accuracy within ±10% of actual BW, which exceeded routine abdominal palpation (60.4%) (P = 0.019). The algorithmic BW prediction was significantly more accurate than routine abdominal palpation in women with the following characteristics: BW 2500–4000 g, multiparous, pre-pregnancy weight <50 kg, current weight <60 kg, height <155 cm, body mass index (BMI) <18.5 kg/m2, cervical dilatation 3–5 cm, station <0, intact membranes, SFH 30–39 cm, maternal abdominal circumference (mAC) <90 cm, mid-upper arm circumference (MUAC) <25 cm and female gender of the neonates (P < 0.05).
Conclusion
An overall accuracy of term BW prediction by our simplified algorithms exceeded that of routine abdominal palpation.
Multivariate algorithmic approaches using maternal characteristics to predict birth weight.
| Methods | Prediction within ±10% of actual birth weight, % | |
|---|---|---|
| Abdominal palpation | 55–75 [8], [9] | |
| Ultrasonographya | 57.5 [10], 61.5 [6], 65.3% [11], 84.1 [9] | |
| Multivariate algorithms | ||
| 1. | EFW (g)=SFH×AG | 53.5 [6] |
| 2. | EFW (g)=−3198−(122.3×presentation)+[94.9×GA (weeks)]+[93.5×SFH (cm)]−(97.4×fetal gender)+(87.1×parity) | 61.6 [9] |
| 3. | EFW (g)=100 [(SFH (cm)]−5] plus 100 if head engaged | 68.1 [8] |
| 4. | EFW (g)=1485.61+[SFH (cm)×23.37]+[11.62 (cm)×mAC]+(BMI×−6.81)+[parity (0=nulliparous, 1=multiparous)×72.25] | 72.7 [9] |
aDifference in the inclusion criteria and the equation used to estimate fetal weight. AG, abdominal girth; BMI, body mass index; EFW, estimated fetal weight; GA, gestational age; mAC, maternal abdominal circumference; SFH, symphysis-fundal height.
Acknowledgments
The authors want to thank Suparat Jaingam for her administrative assistance.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: Siriraj Research Development Fund (managed by Routine to Research: R2R).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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