Predictors Of Birth Weight Research Articles

Evaluation of placental vascularization indices in monochorionic diamniotic and dichorionic diamniotic twin pregnancies

ObjectivesWe aimed to investigate and compare placental vascularization indices between monochorionic-diamniotic, dichorionic-diamniotic normal twin pregnancies, and normal singular pregnancies. We hypothesized that there is correlation between placental three-dimensional power Doppler vascularization indices and birth weight in case of twin pregnancies, and that normal singular pregnancies have higher placental vascularization indices than normal twin pregnancies. Study designPlacental three-dimensional power Doppler vascularization indices, such as vascularization index, flow index, and vascularization-flow index were measured in monochorionic-diamniotic (N = 15) and dichorionic-diamniotic (N = 36) normal twin pregnancies, and in normal singular (N = 109) pregnancies. Correlations were analyzed between vascularization indices, and birth weight, APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess. ResultsVascularization indices and birth weight were significantly (p < 0.01) higher in normal singular gestations (vascularization index = 10.36, flow index = 46.08, vascularization-flow index = 4.08, average birth weight = 3377 g at 38.2 weeks average gestational age) compared to monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. No significant differences were found in vascularization indices between monochorionic-diamniotic and dichorionic-diamniotic normal twins. There were no significant differences in APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess between groups examined (p < 0.01). We found strong linear correlations between placental vascularization indices and birth weight in both twin groups. ConclusionPlacental three-dimensional power Doppler vascularization indices seem appropriate for predicting birth weight in monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. Our pilot study revealed reference values for vascularization indices in case of twin pregnancies examined.

Can we improve the gestation-adjusted projection (GAP) method for prediction of birth weight in morbidly obese women?

Objective: The gestation-adjusted projection (GAP) is a method to predict birthweight using population birth data and third trimester ultrasound fetal weight. This method usually utilizes population birth weight data from almost 40 years ago. In 2011, a large cohort of racially diverse infants across the US was included to validate updated birth curves. Our objective was to determine if the updated data would improve the accuracy of the GAP method during the third trimester among obese women.Methods: This secondary analysis of a cohort study included singleton pregnancies of obese women who had fetal growth assessment(s) in the third trimester. The first subgroup (N = 235) included women with a BMI >40 kg/m2 who had ultrasounds during 30 + 0–35 + 0 weeks (EARLY) and greater than 35 + 0 weeks (LATE). The second subgroup (N = 431) included women with a BMI 30–35, 40–50, or >50 kg/m2 who had an ultrasound during 34 + 0–36 + 6 weeks. Mean absolute percent error was calculated for all GAP methods and compared using paired t-tests. Sensitivity, specificity, and area under the curve for diagnosis of birth weight >4000 grams were also estimated for each GAP method.Results: The mean absolute percent error for the first subgroup (N = 235) using historical population birth weights was 7.4–7.9%. After using updated population birth weight curves using all neonates, the mean absolute percent error for the first subgroup ranged between 7.6 and 9.4%. GAP predictions using all neonates, as well as male and female-specific birth data compared to the historical population data during both the EARLY and LATE periods were significantly worse (p < .01). The mean absolute percent error for the second subgroup (N = 431) using historical population birth weights ranged from 7.2 to 7.9%. The absolute percent error using gender-specific compared to historical data was significant in the BMI 30–35 group (male 8.1% versus historical 7.6%, p < .01, female 8.1% versus historical 7.6%, p < .01). The differences in absolute percent error between historical and updated population data became less evident in the BMI 40–50 and >50-kg/m2 groups (p = .05 and p = .15, respectively) though still overall performed worse with the updated data.Conclusions: Prediction of birth weight using the GAP method does not seem to be improved among obese women after using updated population data. Alternatively, modeling techniques may need to be applied to improve the accuracy of the GAP method.

A New Model for Birth Weight Prediction Using 2- and 3-Dimensional Ultrasonography by Principal Component Analysis: A Chinese Population Study.

To establish a new model for birth weight prediction using 2- and 3-dimensional ultrasonography (US) by principal component analysis (PCA). Two- and 3-dimensional US was prospectively performed in women with normal singleton pregnancies within 7 days before delivery (37-41 weeks' gestation). The participants were divided into a development group (n = 600) and a validation group (n = 597). Principal component analysis and stepwise linear regression analysis were used to develop a new prediction model. The new model's accuracy in predicting fetal birth weight was confirmed by the validation group through comparisons with previously published formulas. A total of 1197 cases were recruited in this study. All interclass and intraclass correlation coefficients of US measurements were greater than 0.75. Two principal components (PCs) were considered primary in determining estimated fetal birth weight, which were derived from 9 US measurements. Stepwise linear regression analysis showed a positive association between birth weight and PC1 and PC2. In the development group, our model had a small mean percentage error (mean ± SD, 3.661% ± 3.161%). At least a 47.558% decrease in the mean percentage error and a 57.421% decrease in the standard deviation of the new model compared with previously published formulas were noted. The results were similar to those in the validation group, and the new model covered 100% of birth weights within 10% of actual birth weights. The birth weight prediction model based on 2- and 3-dimensional US by PCA could help improve the precision of estimated fetal birth weight.

First-trimester irisin and fetuin-A concentration in predicting macrosomia

Objective: We investigated the diagnostic value of first-trimester adipokines and placental markers in predicting macrosomia.Methods: Out of 328 women recruited during the prenatal diagnosis between 11th and 13th week of pregnancy and subjected to follow up until delivery, we selected 26 women who gave birth to macrosomic babies and 34 women who gave birth to normal weight neonates for the evaluation of first trimester serum levels of pregnancy associated plasma protein-A, free β-human chorionic gonadotropin, placental growth factor (PIGF), and selected adipokines.Results: The mothers of macrosomic infants had higher PIGF (p = .049) and irisin concentrations (p = .00003), and lower fetuin-A levels (p = .0002) than had the mothers of normal weight babies. Newborn’s weight correlated positively with maternal irisin (R = 0.454, p = .0003) and negatively with fetuin-A concentrations (R = −0.497, p = .00005). Multiple regression analysis showed that only serum irisin concentration was a significant predictor of birth weight (β = 0.329, p = .03), explaining 14% of its variability. The sensitivity and the specificity of irisin concentration in predicting macrosomia were 0.769 and 0.794, respectively (AUC = 0.818 [95%CI: 0.708–0.928], p = .00001) with a proposed cut-off value of 1725.4 ng/ml.Conclusions: Our results suggest that mother’s irisin may be an early biomarker of macrosomia.

Gestational weight gain among minority adolescents predicts term birth weight.

In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers≤18years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ=0.36, P<0.0001), but BMI was not (ρ=0.025, P=0.61). On regression analysis, gestational weight gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval(CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

Mindfulness skills during pregnancy: Prospective associations with mother's mood and neonatal birth weight

ObjectivesMindfulness skills have been associated with better mood and several health related outcomes. Because depressed mood during pregnancy has been related to worse child outcomes, the aim was to examine the association of mindfulness skills during pregnancy with the mother's depressive symptoms, gestational age, and neonatal birth weight. MethodsA subsample of 905 pregnant women who participated in the longitudinal cohort HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year) completed the 12-item Three Facet Mindfulness-Questionnaire-Short Form at 22weeks of gestation. The Edinburgh Depression Scale was completed to assess depressive symptoms at 12, 22 and 32weeks. The obstetric medical records were examined for gestational age and birth weight. ResultsMindfulness skills Acting with Awareness and Nonjudging at 22weeks were associated with less depressive symptoms at 22weeks and at 32weeks. When controlled for depressive symptoms at 22weeks, the association was still significant for Nonjudging predicting depressive symptoms at 32weeks (Beta=−0.12, p<0.01). Regarding the obstetric medical records, only Nonreacting was (positively) associated with birth weight (Beta=0.09, p<0.01). Controlling for gestational age, sex, parity, depressive symptoms, and health behavior, Nonreacting predicted a normal birth weight (OR=1.12, 95% CI=1.06–1.19), in contrast to low birth weight. ConclusionIt seems that different mindfulness skills during pregnancy are important in predicting mother's depressive symptoms compared to the prediction of child's birth weight. Potential mechanisms are discussed.

Predictive factors for birth weight of newborns of mothers with gestational diabetes mellitus

AimsTo evaluate the predictive factors of birth weight (BW) of newborns of women with gestational diabetes mellitus (GDM). MethodsA cross-sectional study was performed among pregnant women with GDM treated in a public maternity unit, Brazil. We selected 283 pregnant women, with nutritional follow-up initiated till the 28th gestational week, singleton pregnancy, without chronic diseases and with birth weight information of the newborns. The predictive factors of BW were identified by multivariate linear regression. ResultsMean maternal age was 31.2 ± 5.8 years; 64.4% were non-white; 70.1% were pre-gestational overweight or obese. Mean BW was 3234.3 ± 478.8 g. An increase of 1 kg of weight in the first and third trimesters increased BW by 21 g (p = 0.01) and 27 g (p = 0.03), respectively. Similarly, the other predictive factors of BW were pre-gestational body mass index (β = 17.16, p = 0.02) and postprandial plasma glucose in the third trimester (β = 4.14, p = 0.008), in the model adjusted by gestational age at delivery (β = 194.68, p < 0.001). ConclusionsThe best predictors of BW were gestational age at birth, and maternal pre-gestational and gestational anthropometric characteristics. Maternal glycaemic levels may also influence BW. The results may contribute to a review of prenatal routines for pregnant women with GDM.

Role of Umbilical Cord Cross Sectional Area (UCCSA) in Prediction of Neonatal Birth Weight

Role of Umbilical Cord Cross Sectional Area (UCCSA) in Prediction of Neonatal Birth Weight

447: Tried-and-true versus up-and-coming: Which intrauterine growth curve best predicts small-for-gestational age at birth?

To compare a traditional U.S. sonographic method for estimated weight (EFW) and intrauterine growth assessment with two recently published methods for the prediction of small-for-gestational age (SGA) at birth. We reviewed deliveries at our institution from January 1, 2013 to March 31, 2017. Singleton, non-anomalous, well-dated fetuses with an ultrasound within two weeks of delivery were included. EFWs were calculated and percentiles assigned using a traditional U.S. method (Hadlock, 1985) and two newer methods: Intergrowth-21st (INTG, 2016) and Salomon (2007). The Intergrowth-21st method is based on a diverse international population, and the Salomon method is derived from the population in Paris, France. Each method used different formulas for both the calculation of EFW and percentile (z score). Fetal growth restriction (FGR) was defined as EFW <10th percentile. We calculated the test characteristics for each method to predict SGA at birth, which was defined as birth weight <10th percentile using a nationwide U.S. cohort. The true positive rates were plotted graphically as a function of the false positive rates for each method to illustrate receiver-operator characteristics and compare each method’s balance of true and false positives. The mean percentile discrepancies between EFW and birth weight measurements were calculated as a measure of method accuracy. Statistical inference was made using ANOVA or Chi-square as appropriate. Of the 831 pregnancies with an ultrasound within 2 weeks of delivery, 138 (16.7%) were SGA at birth. While Hadlock identified more fetuses for FGR than either INTG or Salomon (p<0.01), it also most accurately predicted the birth weight percentile (p<0.001). Compared with the newer methods, the Hadlock method had the highest sensitivity and negative predictive value as well as the best performance on the receiver operator characteristics graph. For each additional case of SGA predicted with the Hadlock method, one false positive was created. The traditional Hadlock method identified more fetuses as having FGR and more accurately predicted birth weight percentile than either the INTG or Salomon methods. In spite of publication more than 30 years ago, it is superior to newer alternatives.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Correlation of Predicted Birth Weight at 20–24 Weeks of Gestational Age using the Formula devised by Chi-Feng Su to Actual Birth Weight

Correlation of Predicted Birth Weight at 20–24 Weeks of Gestational Age using the Formula devised by Chi-Feng Su to Actual Birth Weight

Developmental patterns of fetal fat and corresponding signal on T1-weighted magnetic resonance imaging.

Evaluation of subcutaneous fetal fat layer thickness on T1-weighted sequences can be used to predict birth weight. Little is known about normal MR signal patterns of subcutaneous tissue throughout pregnancy. To establish developmental patterns of subcutaneous fetal fat signal on T1-weighted sequences during the 2nd and 3rd trimesters. We retrospectively examined T1-weighted images of 110 fetal MRI scans. We measured signal intensity of subcutaneous fat on thighs, buttocks, trunk, nuchal region, chin and scalp. We then calculated the ratios of the obtained values with fetal muscle, amnios and maternal fat signal, and compared the results with those of immunohistochemical examination of adipose tissue extracted from the abdominal wall of fetuses as part of standard autopsy protocol. We included 60 MRI scans in fetuses without intra-uterine growth restriction or macrosomia of non-diabetic mothers (range 23-37weeks of gestation). Fat T1 intensity of all anatomical regions was low in all fetuses before 26weeks of gestation. It became more hyperintense with increasing gestational age, in the following order: chin and nuchal region, then buttocks, thighs and trunk, and eventually the scalp at 33weeks of gestation. After 33weeks of gestation, all fetal subcutaneous tissues demonstrated overall hyperintense signal. This progression followed the conversion at immunohistochemistry of fetal adipose tissue composition from predominant brown to white adipose cells in 19 fetuses (19-41weeks of gestation). Between 26weeks and 33weeks of gestation, subcutaneous fetal fat signal changed in an orderly pattern from chin to buttocks and scalp. This may reflect the conversion from predominant brown to white adipose tissues in subcutaneous fetal fat.

Predicting birth weight in fetuses with gastroschisis.

To determine the accuracy of commonly utilized ultrasound formulas for estimating birth weight (BW) in fetuses with gastroschisis. A retrospective review was conducted of all inborn pregnancies with gastroschisis within the five institutions of the University of California Fetal Consortium (UCfC) between 2007 and 2012. Infants delivered at ⩾28 weeks who had an ultrasound within 21 days before delivery were included. Prediction of BW was evaluated for each of the five ultrasound formulas: Hadlock 1 (abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC)) and Hadlock 2 (AC, BPD and FL), Shepard (AC and BPD), Honarvar (FL) and Siemer (BPD, occipitofrontal diameter (OFD), and FL) using Pearson's correlation, mean difference and percent error and Bland-Altman analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the ultrasound diagnosis of intrauterine growth restriction (IUGR) were assessed. We identified 191 neonates born with gastroschisis within the UCfC, with 111 neonates meeting the inclusion criteria. The mean gestational age at delivery was 36.3±1.7 weeks and the mean BW was 2448±460 g. Hadlock (1) formula was found to have the best correlation (r=0.81), the lowest mean difference (8±306 g) and the lowest mean percent error (1.4±13%). The Honarvar and Siemer formulas performed significantly worse when compared with Hadlock 1, with a 13.7% (P<0.001) and 3.9% (P=0.03) difference, respectively, between estimated and actual BW. This was supported by Bland-Altman plots. For Hadlock 1 and 2, sensitivity was 80% with a NPV of 91%. The widely used Hadlock (1) and (2) formulas provided the best estimated BW in infants with gastroschisis despite its inclusion of abdominal circumference. Furthermore, this formula performs well with diagnosis of IUGR.

Prenatal prediction of small-for-gestational age neonates using MR imaging: comparison with conventional 2D ultrasound

Purpose: The purpose of this study is to evaluate the performance of estimating fetal weight (EFW) using magnetic resonance (MR) imaging as compared with two-dimensional (2D) ultrasound (US) in the prediction of small-for-gestational age neonates (SGA).Materials and methods: Written informed consent was obtained for this Ethical Committee approved study. Between March 2011 and May 2016, women with singleton pregnancies underwent US-EFW and MR-EFW within 48 h before delivery. US-EFW was based on Hadlock et al. and MR-EFW on the formula described by Backer et al. after planimetric measurement of the fetal body volume (FBV). Our outcome measure was performance in prediction of small-for-gestational age neonates by MR imaging versus US-EFW, using receiver-operating characteristic (ROC) curves.Results: Two hundred and seventy women were included in the study with 18 newborns (6.7%) of birthweight ≤10th, 12 (4.5%) ≤ 5th and 7 (2.6%) ≤ 3rd centile. The area under the ROC curve for prediction of birthweight ≤10th centile by prenatal MR imaging was significantly better than by US (difference between the AUROC = 0.060, p = .01; standard error = 0.023). Similarly, the area under the ROC curve for prediction of birthweight ≤5th centile by prenatal MR imaging was significantly better than by US (difference between the AUROC = 0.019, p = .03; standard error = 0.009). Finally, there was no significant difference between the areas under the ROC curve for the prediction of birthweight ≤3rd centile between the two imaging modalities (difference between the AUROC = 0.021, p = .13; standard error = 0.014).Conclusion: MR-EFW performed immediately prior to delivery predicts SGA neonates significantly better than US-EFW.

Amniotic Fluid Arginine from Gestational Weeks 13 to 15 Is a Predictor of Birth Weight, Length, and Head Circumference.

Arginine is a constituent of proteins and a precursor for polyamines and nitric oxide, and is essential for placentation, angiogenesis, and growth. Maternal plasma arginine concentrations are found to be lower in pregnancies complicated by fetal growth restriction, and arginine supplementation in later pregnancy is reported to increase birth weight. We measured arginine and the metabolites asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in the amniotic fluid obtained in pregnancy weeks 13 to 15 from 363 pregnancies with a documented normal outcome and related the concentrations to birth weight, length, and head circumference. Arginine was higher in the amniotic fluid from female (mean 40.8 (SD 10.6) µmol/L) compared to male fetuses (37.4 (SD 11.2) µmol/L, p = 0.003). Despite the gender difference, arginine in the amniotic fluid from gestational weeks 13–15 was the strongest predictor for birth weight, length, and head circumference. ADMA was a strong predictor for birth weight and length, SDMA for birth weight, while Arg/ADMA and Arg/SDMA only predicted head circumference in multiple linear regression models. Due to increased arginine demands, pregnancy is considered a state of relative arginine deficiency. Our findings reflect the importance of a good maternal arginine status in early pregnancy, an observation that should be evaluated in an intervention study.

Third trimester ultrasound for fetal macrosomia: optimal timing and institutional specific accuracy

Purpose: To determine the performance of third trimester ultrasound in women with suspected fetal macrosomia.Materials and methods: We performed a retrospective cohort study of fetal ultrasounds from January 2004 to December 2014 with estimated fetal weight (EFW) between 4000 and 5000 g. We determined accuracy of birth weight prediction for ultrasound performed at less than and greater than 38 weeks, accounting for diabetic status and time between ultrasound and delivery.Results: There were 405 ultrasounds evaluated. One hundred and twelve (27.7%) were performed at less than 38 weeks, 293 (72.3%) at greater than 38 weeks, and 91 (22.5%) were performed in diabetics. Sonographic identification of EFW over 4000 g at less than 38 weeks was associated with higher correlation between EFW and birth weight than ultrasound performed after 38 weeks (71.5 versus 259.4 g, p < .024). EFW to birth weight correlation was within 1.7% of birth weight for ultrasound performed less than 38 weeks and within 6.5% of birth weight for ultrasound performed at greater than 38 weeks.Conclusions: Identification of EFW with ultrasound performed less than 38 weeks has greater reliability of predicting fetal macrosomia at birth than measurements performed later in gestation. EFW to birth weight correlation was more accurate than previous reports.

Short Communication: Birth weight of a Holstein calf based on forefoot circumference

Salman LB, Djaja W, Anang A, Indrijani H, Partasasmita R. 2017. Birth weight of a Holstein calf based on forefoot circumference. Nusantara Bioscience 9: 367-370. Record of birth weight of Holstein calf can be used as consideration for selection. The purpose of this study is to determine the accuracy of birth weight based on regular measuring tape compared to Calf scale BW Tape. The records of calf’s birth weight were collected from 1370 female calf birth records from PT Taurus Dairy Farm, Sukabumi. Birth weight measurements were performed by (i) measuring birth weight using Calf scale BW Tape (Nasco, Fort Atkinson, WI); (ii) predicting birth weight with regression based on the circumference of the right front toenails using regular measuring tape a day after the calf was born; (iii) weighing the calf with the scales. The results showed that the predicted birth weight of dairy cow’s calves can be done by regular measuring tape with a polynomial regression equation, Y=(-6288,6)+(1378.8X)-(113.0X2)+(4.1X3)-(0.056X4), which has a deviation 0.5%, and 7.4% using Calfscale BW Tape. Conclusion of this research is that predicting birth weight of dairy cow’s calves using regular measuring tape is more accurate than using Calfscale BW Tape

Comparison of conventional 2D ultrasound to magnetic resonance imaging for prenatal estimation of birthweight in twin pregnancy

During prenatal follow-up of twin pregnancies, accurate identification of birthweight and birthweight discordance is important to identify the high-risk group and plan perinatal care. Unfortunately, prenatal evaluation of birthweight discordance by 2-dimensional ultrasound has been far from optimal. The objective of the study was to prospectively compare estimates of fetal weight based on 2-dimensional ultrasound (ultrasound-estimated fetal weight) and magnetic resonance imaging (magnetic resonance-estimated fetal weight) with actual birthweight in women carrying twin pregnancies. Written informed consent was obtained for this ethics committee-approved study. Between September 2011 and December 2015 and within 48 hours before delivery, ultrasound-estimated fetal weight and magnetic resonance-estimated fetal weight were conducted in 66 fetuses deriving from twin pregnancies at 34.3-39.0 weeks; gestation. Magnetic resonance-estimated fetal weight derived from manual measurement of fetal body volume. Comparison of magnetic resonance-estimated fetal weight and ultrasound-estimated fetal weight measurements vs birthweight was performed by calculating parameters as described by Bland and Altman. Receiver-operating characteristic curves were constructed for the prediction of small-for-gestational-age neonates using magnetic resonance-estimated fetal weight and ultrasound-estimated fetal weight. For twins 1 and 2 separately, the relative error or percentage error was calculated as follows: (birthweight - ultrasound-estimated fetal weight (or magnetic resonance-estimated fetal weight)/birthweight)× 100 (percentage). Furthermore, ultrasound-estimated fetal weight, magnetic resonance-estimated fetal weight, and birthweight discordance were calculated as 100× (larger estimated fetal weight-smaller estimated fetal weight)/larger estimated fetal weight. The ultrasound-estimated fetal weight discordance and the birthweight discordance were correlated using linear regression analysis and Pearson's correlation coefficient. The same was done between the magnetic resonance-estimated fetal weight and birthweight discordance. To compare data, the χ2, McNemar test, Student t test, and Wilcoxon signed rank test were used as appropriate. We used the Fisher r-to-z transformation to compare correlation coefficients. The bias and the 95% limits of agreement of ultrasound-estimated fetal weight are 2.99 (-19.17% to 25.15%) and magnetic resonance-estimated fetal weight 0.63 (-9.41% to 10.67%). Limits of agreement were better between magnetic resonance-estimated fetal weight and actual birthweight as compared with the ultrasound-estimated fetal weight. Of the 66 newborns, 27 (40.9%) were of weight of the 10th centile or less and 21 (31.8%) of the fifth centile or less. The area under the receiver-operating characteristic curve for prediction of birthweight the 10th centile or less by prenatal ultrasound was 0.895 (P < .001; SE, 0.049), and by magnetic resonance imaging it was 0.946 (P < .001; SE, 0.024). Pairwise comparison of receiver-operating characteristic curves showed a significant difference between the areas under the receiver-operating characteristic curves (difference, 0.087, P= .049; SE, 0.044). The relative error for ultrasound-estimated fetal weight was 6.8% and by magnetic resonance-estimated fetal weight, 3.2% (P < .001). When using ultrasound-estimated fetal weight, 37.9% of fetuses (25 of 66) were estimated outside the range of ±10% of the actual birthweight, whereas this dropped to 6.1% (4 of 66) with magnetic resonance-estimated fetal weight (P < .001). The ultrasound-estimated fetal weight discordance and the birthweight discordance correlated significantly following the linear equation: ultrasound-estimated fetal weight discordance= 0.03+ 0.91× birthweight (r= 0.75; P < .001); however, the correlation was better with magnetic resonance imaging: magnetic resonance-estimated fetal weight discordance= 0.02+ 0.81× birthweight (r= 0.87; P < .001). In twin pregnancies, magnetic resonance-estimated fetal weight performed immediately prior to delivery is more accurate and predicts small-for-gestational-age neonates significantly better than ultrasound-estimated fetal weight. Prediction of birthweight discordance is better with magnetic resonance imaging as compared with ultrasound.

Screening Performance of Placental Growth Factor for the Prediction of Low Birth Weight and Adverse Intrapartum and Neonatal Outcomes in a Term Low-Risk Population

Introduction: Fetuses who fail to reach their genetic growth potential are thought to have sub-optimal placental function. Low placental growth factor (PlGF) levels have been shown to be predictive of placentally mediated conditions, such as pre-eclampsia or fetal growth restriction. We investigated the screening performance of PlGF for the prediction of low birth weight (<10th centile for gestation) and adverse intrapartum and neonatal outcomes in apparently low-risk term pregnancies. Materials and Methods: Maternal PlGF levels were measured fortnightly in a blinded, prospective, observational study from 36 weeks of pregnancy. Women and clinicians were blinded to PlGF results, and pregnancies were managed according to local policies and guidelines. Intrapartum and neonatal outcomes were recorded. PlGF was analysed for association with, and predictive capacity for, low birth weight, caesarean section for intrapartum fetal compromise (CS-IFC) and adverse neonatal outcomes. Results: A total of 438 women were included in the final analysis. Lower PlGF levels were associated with low birth weight, CS-IFC and adverse neonatal outcome. For a false-positive rate of 10 and 20%, respectively, the corresponding sensitivities were 9.7-11.1% and 22.2-26.8%. Conclusion: As a sole predictor for low birth weight, CS-IFC and adverse neonatal outcome, PlGF was poor as a test.

Assessment of the Role of Maternal Characteristics, Mental Health and Maternal Marital Satisfaction in Prediction of Neonatal Birth Weight

Background Neonatal mortality comprises a large part of infant mortality, and it depends largely on neonatal birth weight. Besides maternal diseases, it seems that other important factors such as maternal demographic characteristics, mental health and marital satisfaction, affects their infants birth weight. This study conducted aiming to evaluate these affecting factors on neonatal birth weight. Materials and Methods  This study was descriptive � correlative, and conducted on all of the mothers and their neonates who were 200 mothers and neonates born during the summer 2015, in Urmia Kosar hospital that lasted 6 months. We used the GHQ (General Health Questionnaire), to evaluate the mental status of mothers and ENRICH for the evaluation of marital satisfaction. Demographic characteristics of mothers collected to special forms. Results In this study, 200 mothers, and 200 neonates born in Kosar Hospital were studied. The mean age of the mothers was 28.06 ± 6.34 years and the duration of pregnancy was 39.14 ± 1.21 months. The amount of obtained was significant for pregnancy duration in predicting neonatal birth weight. In marital status parameters, beta amounts for economic, family and communication was significant in predicting neonatal birth weight. Among parameters of maternal mental health, correlation of depression was significant in predicting neonatal birth weight. Conclusion According to results, in white race low maternal age was a risk factor for bearing low birth weight baby. Marital satisfaction and bearing no stress from husband lets the fetus grow well and reaches normal birth weight.

Gestational Weight Gain and its Relation with Birth Weight of the Newborn

Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 84 (37%) overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to recommendation. Excess weight gain was seen in 34 (15%) women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn. There is a positive correlation between gestational weight gain of the women and birth weight of the newborn.