National Institute of Health and Medical Research Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris-Descartes University, Paris, France; Antoine Béclère Maternity Unit, Department of Obstetrics and Gynecology, University Paris Sud, Assistance Publique-Hôpitaux de Paris, Paris, France.
University Grenoble Alpes, CNRS, Public Health Department Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Institute of Engineering University Grenoble Alpes, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble, Grenoble, France; National Institute of Health and Medical Research Center for Clinical Investigation U1406, Grenoble, France.
Am J Obstet Gynecol. 2018 Nov;219(5):476.e1-476.e12. doi: 10.1016/j.ajog.2018.08.012. Epub 2018 Aug 14.
Accurate estimation of fetal weight is needed for growth monitoring and decision-making in obstetrics; the INTERGROWTH project developed an estimated fetal weight formula to construct new intrauterine growth standards.
We sought to compare the accuracy of the Hadlock and INTERGROWTH formulas for the estimation of fetal weight among preterm infants.
Using the EPIPAGE 2 population-based study of births between 22-34 weeks of gestation, we included 578 nonanomalous singleton fetuses with an ultrasound-to-delivery interval <2 days. We used abdominal circumference, head circumference, and femur length to calculate estimated fetal weight with Hadlock formula and abdominal and head circumferences to calculate estimated fetal weight according to INTERGROWTH. The mean percentage errors and the proportions of estimated fetal weight measures within ±10% of birthweight were compared between the 2 methods.
Mean (SD) gestational age and birthweight were 29.1 (SD 2.7) weeks and 1219 (SD 489) g. Mean (SD) percentage errors for Hadlock and INTERGROWTH were significantly different: -0.7 (SD 10.1) and -3.5 (SD 11.6), respectively (P < .001), and more infants were classified within ±10% of their birthweight with Hadlock compared to INTERGROWTH (68.7% vs 57.8%, P < .001). The INTERGROWTH formula overestimated birthweight at 22-23 weeks compared to Hadlock [mean errors of 18.8 (SD 13.6) vs 5.5 (SD 10.2)] and underestimated birthweight >28 weeks: at 29-31 weeks, mean errors were -5.8 (SD 10.9) for INTERGROWTH and -0.6 (SD 10.4) for Hadlock.
Hadlock estimated fetal weight formula was more accurate than INTERGROWTH formula for fetuses delivered between 22-34 weeks of gestation. Our results support continued use of Hadlock formula in France and raise questions about the applicability of INTERGROWTH intrauterine growth standards.
准确估计胎儿体重对于监测胎儿生长和做出产科决策至关重要；INTERGROWTH 项目制定了一种估算胎儿体重的公式，以构建新的宫内生长标准。
我们旨在比较 Hadlock 和 INTERGROWTH 公式在预测早产儿胎儿体重方面的准确性。
利用 EPIPAGE 2 基于人群的 22-34 周妊娠分娩研究，我们纳入了 578 例无畸形的单胎胎儿，超声至分娩的时间间隔<2 天。我们使用腹围、头围和股骨长来计算 Hadlock 公式估算的胎儿体重，使用腹围和头围来计算 INTERGROWTH 公式估算的胎儿体重。比较两种方法计算的胎儿体重估计值的平均百分比误差和与出生体重相差±10%的比例。
平均（SD）胎龄和出生体重分别为 29.1（SD 2.7）周和 1219（SD 489）g。Hadlock 和 INTERGROWTH 的平均（SD）百分比误差明显不同：分别为-0.7（SD 10.1）和-3.5（SD 11.6）（P<0.001），与 INTERGROWTH 相比，Hadlock 法计算的胎儿体重在±10%出生体重范围内的婴儿比例更高（68.7% vs 57.8%，P<0.001）。与 Hadlock 相比，INTERGROWTH 公式在 22-23 周时高估了出生体重[平均误差为 18.8（SD 13.6）与 5.5（SD 10.2）]，而在>28 周时低估了出生体重：在 29-31 周时，INTERGROWTH 的平均误差为-5.8（SD 10.9），Hadlock 的平均误差为-0.6（SD 10.4）。
Hadlock 估算胎儿体重公式在预测 22-34 周妊娠分娩的胎儿体重方面比 INTERGROWTH 公式更准确。我们的结果支持在法国继续使用 Hadlock 公式，并对 INTERGROWTH 宫内生长标准的适用性提出质疑。
