Customised estimated fetal weight centiles in the prediction of intrauterine growth restriction (IUGR)

Abstract

The aims of this paper were (1) to determine the value of third trimester customised estimated fetal weight centile ranking in the prediction of infants born with anthropometric features of IUGR and (2) to compare the performance of customised centiles with ultrasound fetal growth velocity in the prediction of IUGR. Two-hundred and seventy women with low-risk pregnancies participated in a longitudinal study of fetal biometry. Third trimester customised estimated fetal weight centiles (cEFW) were obtained after adjustment for gestational age at the time of ultrasound, birth order and gender, maternal weight, height and ethnic origin (www.wmpi.net). Fetal growth velocity was calculated using the increment in the fetal abdominal area (FAA) over a mean 28-day interval with reference to published standards. IUGR was defined as neonatal ponderal index (PI) < 25th centile. The mean cEFW centiles for cases with and without IUGR were 22.8 vs. 42.7 (P < 0.01). cEFW centile < 5 had LR of 6.8 (4.5–10.6) for IUGR; cEFW centile < 10 had LR of 4.1 (2.5–7.2) for IUGR. In the prediction of IUGR, the FAA velocity LR for a positive test was higher than the LR for the 5th cEFW (P = 0.014) and for the 10th cEFW (P ≤ 0.001).