Prediction of adverse perinatal outcome by fetal biometry: comparison of customized and populationâ based standards

ObjectiveTo compare the predictive performance of estimated fetal weight (EFW) percentiles, according to eight growth standards, to detect fetuses at risk for adverse perinatal outcome.MethodsThis was a retrospective cohort study of 3437 Africanâ American women. Populationâ based (Hadlock, INTERGROWTHâ 21st, World Health Organization (WHO), Fetal Medicine Foundation (FMF)), ethnicityâ specific (Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)), customized (Gestationâ Related Optimal Weight (GROW)) and Africanâ American customized (Perinatology Research Branch (PRB)/NICHD) growth standards were used to calculate EFW percentiles from the last available scan prior to delivery. Prediction performance indices and relative risk (RR) were calculated for EFW â 90th percentiles, according to each standard, for individual and composite adverse perinatal outcomes. Sensitivity at a fixed (10%) falseâ positive rate (FPR) and partial (FPR â 90th percentile were also at risk for any adverse perinatal outcome according to the INTERGROWTHâ 21st (RRâ =â 1.4; 95%â CI, 1.0â 1.9) and Hadlock (RRâ =â 1.7; 95%â CI, 1.1â 2.6) standards, many times fewer cases (2â 5â fold lower sensitivity) were detected by using EFW >â 90th percentile, rather than EFW â 90th percentile were at increased risk of adverse perinatal outcomes according to all or some of the eight growth standards, respectively. The RR of a composite adverse perinatal outcome in pregnancies with EFW <â 10th percentile was higher for the mostâ stringent (NICHD) compared with the leastâ stringent (FMF) standard. The results of the complementary analysis of AUC suggest slightly improved detection of adverse perinatal outcome by more recent populationâ based (INTERGROWTHâ 21st) and customized (PRB/NICHD) standards compared with the Hadlock and FMF standards. Published 2019. This article is a U.S. Government work and is in the public domain in the USA.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153734/1/uog20299.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153734/2/uog20299_am.pd