Anat Shmueli1,2, Lina Salman3,4, Eran Hadar3,4, Amir Aviram4,5, Ron Bardin3,4, Eran Ashwal4,5, Rinat Gabbay-Benziv6,7. 1. Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 49100, Israel. anatshmu79@gmail.com. 2. The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. anatshmu79@gmail.com. 3. Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 49100, Israel. 4. The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 6. Hillel Yaffe Medical Center, Hadera, Israel. 7. The Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Abstract
PURPOSE: To evaluate the best performing formula for macrosomia prediction in pregnancies complicated by diabetes. METHODS: A retrospective analysis was performed of 1060 sonographic fetal biometrical measurements performed within 7 days of delivery in term pregnancies (37-42 gestational weeks) complicated by diabetes. Sonographic prediction of macrosomia (≥ 4000, ≥ 4250, and ≥ 4500 g) was evaluated utilizing ten previously published formulas by: (1) calculating for each macrosomia threshold the sensitivity, specificity, positive and negative predictive value, and ± likelihood ratio for macrosomia prediction; (2) comparing the systematic and random error and the proportion of estimates < 10% of birth weights between macrosomic and non-macrosomic neonates. Best performing formula was determined based on Euclidean distance. RESULTS: 97 (9.2%) macrosomic neonates (> 4000 g) were included. Median birth weight was 3380 (1866-3998) g for non-macrosomic and 4198 (4000-5180) g for macrosomic neonates. Higher macrosomia cutoff was associated with higher specificity and lower sensitivity. We found a considerable variation between formulas in different accuracy parameters. Hadlock's formula (1985), based on abdominal circumference, femur length, head circumference and biparietal diameter, had the shortest Euclidean distance, reflecting the highest accuracy. CONCLUSION: Prediction of macrosomia among women with diabetes differs significantly between formulas. In our cohort, the best performing formula for macrosomia prediction was Hadlock's formula (1985).
PURPOSE: To evaluate the best performing formula for macrosomia prediction in pregnancies complicated by diabetes. METHODS: A retrospective analysis was performed of 1060 sonographic fetal biometrical measurements performed within 7 days of delivery in term pregnancies (37-42 gestational weeks) complicated by diabetes. Sonographic prediction of macrosomia (≥ 4000, ≥ 4250, and ≥ 4500 g) was evaluated utilizing ten previously published formulas by: (1) calculating for each macrosomia threshold the sensitivity, specificity, positive and negative predictive value, and ± likelihood ratio for macrosomia prediction; (2) comparing the systematic and random error and the proportion of estimates < 10% of birth weights between macrosomic and non-macrosomic neonates. Best performing formula was determined based on Euclidean distance. RESULTS: 97 (9.2%) macrosomic neonates (> 4000 g) were included. Median birth weight was 3380 (1866-3998) g for non-macrosomic and 4198 (4000-5180) g for macrosomic neonates. Higher macrosomia cutoff was associated with higher specificity and lower sensitivity. We found a considerable variation between formulas in different accuracy parameters. Hadlock's formula (1985), based on abdominal circumference, femur length, head circumference and biparietal diameter, had the shortest Euclidean distance, reflecting the highest accuracy. CONCLUSION: Prediction of macrosomia among women with diabetes differs significantly between formulas. In our cohort, the best performing formula for macrosomia prediction was Hadlock's formula (1985).
Entities:
Keywords:
Diabetes in pregnancy; Fetal weight estimation; Macrosomia