L’utilisation des courbes de poids personnalisées en anténatal améliore-t-elle le diagnostic des fœtus petits pour l’âge gestationnel à haut risque de morbidité néonatale ?

Abstract

ObjectivesTo assess the accuracy of customized growth charts for the ultrasound antenatal diagnostic of fetus small for gestational age in a high-risk population of preterm. MethodsAll premature infants born in a French university maternity center for a year and classified as small for gestational age at birth by using customized growth charts developed by Ego et al. were included in this retrospective study. At the ultrasound performed closest to the term, customized growth charts and population growth curves were compared for the antenatal diagnosis of a premature infants group classified small for gestational age in post-natal by customized growth charts and more at risk of perinatal complications. ResultsSixty-seven newborns were included in the study. Fifty-one (76.1%) were secondarily classified as small for gestational age although they were eutrophic on the basis of population growth curves and 16 (23.9%) were small for gestational age on both curves. The average time between the last ultrasound and birth was 2.2 weeks. On the threshold of the tenth percentile, the sensitivities of customized growth charts and curves in population were not significantly different (29.85% versus 41.79% P=0.05) for antenatal detection of fetus small for gestational age. ConclusionIn our study, the use of customized growth charts does not improve the antenatal detection of most at-risk children.