Accuracy of intrapartum ultrasonographic fetal weight estimation in pregnancy with diabetic mellitus compare with non-diabetic pregnancy: A retrospective cohort study
Keywords:
fetal weight, ultrasound, diabetes, accuracy, birthweightAbstract
The intrapartum fetal weight estimation is crucial for obstetrician decision-making, especially in diabetic mothers. This study aims to assess the accuracy of intrapartum ultrasonographic fetal weight estimation among diabetic mothers and identify factors influencing its accuracy. A retrospective cohort study was conducted, including singleton pregnant women who underwent intrapartum ultrasonographic fetal weight estimation. The accurate estimation group was defined as a percentage difference of fetal weight < 10%, while cases with a > 10% difference were classified as the inaccurate estimation group. The accuracy of estimation between diabetic and non-diabetic patients and the potentially associated factors were compared using multivariable logistic regression analysis. A total of 454 eligible women were included in this study, with 226 in the diabetic group and 228 in the non-diabetic group. In the diabetic group, 61.95% had accurate ultrasonographic fetal weight estimation, while the non-diabetic group had a 63.16% accurate result, with no statistically significant difference (adjusted Risk ratio [ARR]: 1.00; 95% confidence interval [CI] = 0.78-1.28; p=0.998). The factors associated with the accuracy of ultrasonographic fetal weight estimation were birthweight (ARR 1.04 per each 100 g increment; 95% CI = 1.01-1.06; p=0.003) and the examiner’s experience (residents and staff had a lower inaccurate rate than interns, with the ARR: 0.74; 95% CI = 0.58-0.94; p=0.013). The accuracy of intrapartum ultrasonographic fetal weight estimation between diabetic and non-diabetic mothers showed no statistically significant difference. The factors influencing accuracy were the actual birthweight and the level of experience of the examiner.
References
Correa A, Bardenheier B, Elixhauser A, et al. Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993–2009. Matern Child Health J 2015;19:635-42.
Deputy NP, Kim SY, Conrey EJ, et al. Prevalence and changes in preexisting diabetes and gestational diabetes among women who had a live birth—United States, 2012–2016. MMWR Morb Mortal Wkly Rep 2018;67:1201.
Bilous RW, Jacklin PB, Maresh MJ, et al. Resolving the gestational diabetes diagnosis conundrum: the need for a randomized controlled trial of treatment. Diabetes Care 2021;44:858-64.
Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2010;23:199-203.
American College of Obstetricians and Gynecologists. Macrosomia: ACOG practice bulletin, number 216. Obstet Gynecol 2020;135:e18-e35.
Tas EE, Kir EA, Yilmaz G, et al. Accuracy of sonographic fetal weight estimation in full-term singleton pregnant women. Pak J Med Sci 2019;35:34.
Bushman ET, Thompson N, Gray M, et al. Influence of estimated fetal weight on labor management. Am J Perinatol 2020;37:252-7.
McFarland MB, Trylovich CG, Langer O. Anthropometric differences in macrosomic infants of diabetic and nondiabetic mothers. J Matern Fetal Neonatal Med 1998;7:292-5.
Kamana K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab 2015;66:14-20.
Shmueli A, Salman L, Hadar E, et al. Sonographic prediction of macrosomia in pregnancies complicated by maternal diabetes: finding the best formula. Arch Gynecol Obstet 2019;299:97-103.
National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979;28:1039-57.
Meyer R, Rottenstreich A, Tsur A, et al. The effect of fetal weight on the accuracy of sonographic weight estimation among women with diabetes. J Matern Fetal Neonatal Med 2022;35:1747-53.
McFarland MB, Trylovich CG, Langer O. Anthropometric differences in macrosomic infants of diabetic and non diabetic mothers. J Matern Fetal Med 1998;7:292-5.
Alsulyman OM, Ouzounian JG, Kjos SL. The accuracy of intrapartum ultrasonographic fetal weight estimation in diabetic pregnancies. Am J Obstet Gynecol 1997;177:503-6.
Best G, Pressman EK. Ultrasonographic prediction of birth weight in diabetic pregnancies. Obstet Gynecol 2002;99:740-4.
Combs CA, Rosenn B, Midovnik M, et al. Sonographic EFW and macrosomia: is there an optimum formula to predict diabetic fetal macrosomia? J Matern Fetal Med 2000;9:55-61.
Farrell T, Holmes R, Stone P. The effect of body mass index on three methods of fetal weight estimation. BJOG 2002;109:651-7.
Noumi G, Collado-Khoury F, Bombard A, et al. Clinical and sonographic estimation of fetal weight performed during labor by residents. Am J Obstet Gynecol 2005;192:1407-9.
Peregrine E, O’brien P, Jauniaux E. Clinical and ultrasound estimation of birth weight prior to induction of labor at term. Ultrasound Obstet Gynecol 2007;29:304-9.
Faschingbauer F, Dammer U, Raabe E, et al. Intrapartum sonographic weight estimation. Arch Gynecol Obstet 2015;292:805-11.
Su R, Zhu W, Wei Y, et al. Relationship of maternal birth weight on maternal and neonatal outcomes: a multicenter study in Beijing. J Perinatol 2016;36:1061-6.
Ben-Haroush A, Yogev Y, Mashiach R, et al. Accuracy of sonographic estimation of fetal weight before induction of labor in diabetic pregnancies and pregnancies with suspected fetal macrosomia. J Perinat Med 2003;31:225-30.
Mirghani HM, Weerasinghe S, Ezimokhai M, et al. Ultrasonic estimation of fetal weight at term: an evaluation of eight formulae. J Obstet Gynaecol Res 2005;31:409-13.
Anderson N, Jolley I, Wells J. Sonographic estimation of fetal weight: comparison of bias, precision and consistency using 12 different formulae. Ultrasound Obstet Gynecol 2007;30:173-9.
Barel O, Vaknin Z, Tovbin J, et al. Assessment of the accuracy of multiple sonographic fetal weight estimation formulas: a 10 year experience from a single center. J Ultrasound Med 2013;32:815-23.
Wong S, Chan F, Cincotta R, et al. Sonographic estimation of fetal weight in macrosomic fetuses: diabetic versus non diabetic pregnancies. Aust N Z J Obstet Gynaecol 2001;41:429-32.
Siemer J, Egger N, Hart N, et al. Fetal weight estimation by ultrasound: comparison of 11 different formulae and examiners with differing skill levels. Ultraschall Med 2008;29:159-64.
Milner J, Arezina J. The accuracy of ultrasound estimation of fetal weight in comparison to birth weight: A systematic review. Ultrasound 2018;26:32-41.
Little SE, Edlow AG, Thomas AM, et al. Estimated fetal weight by ultrasound: a modifiable risk factor for cesarean delivery? Am J Obstet Gynecol 2012;207:309. e1-e6.
Stubert J, Peschel A, Bolz M, et al. Accuracy of immediate antepartum ultrasound stimated fetal weight and its impact on mode of delivery and outcome-a cohort analysis. BMC Pregnancy Childbirth 2018;18:1-8.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
