Henrichs Christine, Magann Everett F, Brantley Kara L, Crews J Holt, Sanderson Maureen, Chauhan Suneet P
Division of Maternal-Fetal Medicine, Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA.
J Reprod Med. 2003 May;48(5):339-42.
To determine if abdominal circumference (AC) can identify macrosomia (> or = 4,000 g) at or beyond 37 weeks.
Prospectively, parturients at term admitted for delivery underwent sonographic mensuration of AC. A receiver-operating characteristic (ROC) curve was constructed to determine if AC can differentiate between normal (birth weight < 3,999 g) and macrosomia. A likelihood ratio was calculated. P < .05 was considered significant.
The mean gestational age of the 256 subjects was 39.1 +/- 1.5 weeks, and the prevalence of macrosomia was 8.2% (21/256). Inspection of the ROC curve indicated that AC > or = 350 mm can identify macrosomic fetuses. The area under the ROC curve (0.79 +/- 0.04 for macrosomia) was significantly different than the area under the nondiagnostic line (P < .005). The likelihood ratio for AC to detect macrosomia was 2.9 (95% confidence interval, 2.1-4.0). Based on the proportion of macrosomia in our population, we would require over 1,000,000 newborns for a macrosomia analysis to obtain narrow confidence intervals around a clinically useful likelihood ratio.
Using the guidelines proposed by the Evidence-Based Medicine Working Group, AC is slightly useful in detecting macrosomia among term parturients.
确定腹围（AC）能否在孕37周及以后识别巨大儿（出生体重≥4000g）。
前瞻性地，对足月入院分娩的产妇进行AC超声测量。构建受试者工作特征（ROC）曲线以确定AC能否区分正常体重儿（出生体重<3999g）和巨大儿。计算似然比。P<0.05被认为具有统计学意义。
256名受试者的平均孕周为39.1±1.5周，巨大儿患病率为8.2%（21/256）。ROC曲线分析表明，AC≥350mm可识别巨大儿胎儿。ROC曲线下面积（巨大儿为0.79±0.04）与非诊断线以下面积有显著差异（P<0.005）。AC检测巨大儿的似然比为2.9（95%置信区间，2.1 - 4.0）。根据我们研究人群中巨大儿的比例，要对巨大儿进行分析并在临床有用的似然比周围获得狭窄的置信区间，我们需要超过100万新生儿。
根据循证医学工作组提出的指南，AC在足月产妇中对检测巨大儿略有帮助。
