Department of Obstetrics and Gynecology, General Hospital "Nova Gradiška", Nova Gradiška, Croatia.
Department of Obstetrics and Gynecology, UHC Osijek, School of Medicine, University of Osijek, Osijek, Croatia.
J Perinat Med. 2021 Apr 16;49(7):907-914. doi: 10.1515/jpm-2021-0013. Print 2021 Sep 27.
Women with gestational diabetes (GDM) and weight gain during pregnancy above recommended more often give birth to macrosomic children. The goal of this study was to evaluate the diagnostic accuracy of the modified formula for ultrasound assessment of fetal weight created in a pilot study using a similar specimen in comparison to the Hadlock-2 formula.
This is a prospective, cohort, applicative, observational, quantitative, and analytical study, which included 213 pregnant women with a singleton pregnancy, GDM, and pregnancy weight gain above recommended. Participants were consecutively followed in the time period between July 1st, 2016, and August 31st, 2020. Ultrasound estimations were made within three days before the delivery. Fetal weights estimated using both formulas were compared to the newborns' weights.
A total of 133 fetal weight estimations were made. In comparison to the newborns' weight modified formula had significantly smaller deviation in weight estimation compared to the Hadlock-2 formula, higher frequency of deviation within 5% of newborns weights (78.2% [95% CI=0.74-0.83] vs. 60.2%), smaller frequency of deviations from 5 to 10% (19.5 vs. 33.8%) and above 10%, which was even more significant among macrosomic children. There were 36/50 (72%) correctly diagnosed cases of macrosomia by modified and 33/50 (66%) by Hadlock-2 formula. Area under the curve (AUC) for the modified formula was 0.854 (95% CI=0.776-0.932), and for the Hadlock-2 formula 0.824 (95% CI=0.740-0.908). The positive predictive value of the modified formula was 81.81%, the negative 97.91%.
In cases of greater fetal weights, the modified formula showed greater precision.
患有妊娠期糖尿病（GDM）且孕期体重增加超过推荐值的女性，其分娩巨大儿的概率更高。本研究的目的是评估在一项使用类似标本的初步研究中创建的改良超声胎儿体重评估公式的诊断准确性，并与 Hadlock-2 公式进行比较。
这是一项前瞻性、队列、应用、观察、定量和分析研究，纳入了 213 名患有 GDM 且孕期体重增加超过推荐值的单胎妊娠孕妇。在 2016 年 7 月 1 日至 2020 年 8 月 31 日期间，对参与者进行连续随访。在分娩前 3 天内进行超声检查。比较两种公式预测的胎儿体重与新生儿体重的差异。
共进行了 133 次胎儿体重估计。与新生儿体重相比，改良公式在估计体重方面的偏差明显更小，在 5%以内的偏差频率更高（78.2% [95%CI=0.74-0.83] 与 60.2%），5%至 10%之间的偏差频率更小（19.5% 与 33.8%），10%以上的偏差频率更小，这在巨大儿中更为显著。改良公式正确诊断出 36/50（72%）例巨大儿，Hadlock-2 公式正确诊断出 33/50（66%）例巨大儿。改良公式的曲线下面积（AUC）为 0.854（95%CI=0.776-0.932），Hadlock-2 公式的 AUC 为 0.824（95%CI=0.740-0.908）。改良公式的阳性预测值为 81.81%，阴性预测值为 97.91%。
在胎儿体重较大的情况下，改良公式具有更高的准确性。
