Comparison of eleven commonly used formulae for sonographic estimation of fetal weight in prediction of actual birth weight

Objectives: The aim of the study is to compare the accuracy of 11 formulas in predicting fetal weight. Material and methods: The study includes 1072 pregnant women of gestational age from 28 to 42 weeks, who gave birth between January and June 2017. Pregnant women were divided into five groups; group 1, where actual birth weight (ABW) was less than 2500 g, group 2, where ABW was between 2500–4000 g, group 3, where ABW was above 4000 g. Group 4 — newborns with birth weight under 10 percentile and group 5 — newborns with birth weight above 90 percentile. The accuracy of the estimated fetal weight (EFW) was assessed by calculating absolute percentage error (APE) and ‘limits-of-agreement’. R Spearman correlation was utilized between EFW and ABW. Results: The most accurate formula for group 1 is Hadlock3 (MAPE = 7.04%), the narrowest limits of agreement has Combs — [mean (SD): 99.41 g (269.57 g)]. For group 2, the lowest MAPE (5.43%) has Ott, the narrowest limits of agreement belongs to Combs – [mean (SD): -101.36 g (275.88 g)] . For group 3 is Hadlock3 (MAPE = 5.79%), the narrowest limits of agreement has Hadlock5 [mean (SD): -637.32 g (209.59 g)]. For group 4 is Combs (MAPE = 7.72%), the narrowest limits of agreement has Combs [mean (SD): 195.77 g (264.97 g)]. For gr oup 5 is Warsof2 (MAPE = 7.06%), the narrowest limits of agreement has Campbell [mean (SD): 227.81 g (299.26 g)]. Conclusions: Median of absolute percentage error is the most useful parameter to predict birth weight. Each group of fetuses needs different formula to predict the most accurate weight

The relationship between pre-pregnancy BMI, gestational weight gain and neonatal birth weight: a retrospective cohort study

Objectives: Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have a meaningful impact on pregnancy and perinatal outcomes. The first aim of the study was to analyze the association between pre-pregnancy BMI and the prevalence of small for gestational age (SGA) and large for gestational age (LGA) outcomes. The second aim was to assess the relation- ship between pre-pregnancy BMI combined with gestational weight gain (GWG) and the prevalence of SGA and LGA measurements. Material and methods: The retrospective cohort study was conducted at Jagiellonian University Hospital in Cracow, Po- land from 2016 to 2017. During this time there were 2,123 deliveries. Patients with chronic diseases, multiple pregnancies, fetal defects and incomplete data were excluded. Finally, 474 cases were enrolled. Patients were divided into BMI groups (underweight, normal, overweight and obese) and into GWG groups (inadequate, adequate, excessive). Relationships between maternal BMI, GWG and newborn weight were examined. Results: There was no statistically significant association between maternal pre-pregnancy BMI and prevalence of SGA measurements. However, underweight women with inadequate GWG showed a higher risk to bear SGA babies (OR 5.2, 95% CI 1.57-17.18). Obese women with adequate GWG had higher risk of bearing LGA newborns (OR 5.48, 95% CI 1.15–26.13). High BMI correlated with excessive GWG (overweight: OR 3.0, 95% CI 1.84–3.87; obese OR 2.45, 95% CI 1.1–5.48). Conclusions: There is a considerable risk of giving birth to a SGA newborn for underweight women with inadequate GWG. There is a statistically significant association between maternal obesity and LGA outcomes. Our study shows that redefining the risks of abnormal neonatal weight considering both pre-pregnancy BMI and gestational weight gain can be useful in providing effective prevention during pregnancy.

The relevance of Short-Term Variation (STV) value measured within 1 hour before delivery in predicting adverse neonatal outcome

Objectives: Computer CTG analysis (cCTG) included short-term variation (STV) is one of the methods of monitoring fetal condition during delivery. The aim of our study was to define appropriability of STV measured within 1 hour before delivery in prediction of neonatal outcomes. Material and methods: The retrospective study included 1014 pregnant women, who gave birth in the Department of Obstetrics and Perinatology. Participants were divided into two groups: group 1 — term pregnancies (37–41 weeks) and group 2 — preterm pregnancies (lower than 37 weeks). In each of them, two subgroups have been separated: control (STV ≥ 3 ms) and study group (STV < 3 ms). Results: In both groups 1 and 2, there were no statistically significant differences related to Apgar scores in 1st, 3rd and 5th minute between group with STV < 3 ms and group with STV > 3 ms Moreover, for 37–41 weeks the sensitivity, specificity, positive predictive value and negative predictive value were: 22.7%, 83.9%, 3.3% and 97.8% and for lower than 37: 45.7%, 65.4%, 47.1%, 64.2% in 1th minute after delivery. In group 1 the area under curve (AUC) measurements were 0.45 (95% CI: 0.32–0.58) for 1st minute and 0.55 (95% CI: 0.35–0.74) for 5th minute and in group 2: 0.58 (95% CI: 0.45–0.71) for 1th minute and 0.57 (95% CI: 0.42–0.72) for 5th minute.   Conclusions: High specificity and negative predictive value of STV indicates a good Apgar score of newborns in term pregnancies. Analysis of STV in preterm pregnancy is not clear. Fetal well-being in preterm pregnancy should include STV and other non-invasive and invasive tools

ICTP concentration in cervical-vaginal fluid as a potential marker of membrane collagen degradation before labor

Objectives: Numerous physical and chemical processes lead to rupture of membranes. Within the fetal membranes there are numerous types of metalloproteinases, which cause collagen type I degradation. The C-terminal telopeptide of colagen type I (ICTP) is the breakdown product of type I collagen. The aim of the study was to determine whether ICTP is secreted into the vaginal-cervical fluid (VCF) in the case of physiological rupture of the membranes of the fetus before delivery. Material and methods: The study was conducted in March 2021 at the Department of Obstetrics and Perinatology of the Jagiellonian University in Cracow, Poland. Twenty-three cases were included in the study. During routine gynecological examination with the use of specula, VCF was collected twice in a volume of 50 µL. The obtained material was then subjected to enzyme immunoassay using the Human C-telopeptide of type I collagen (ICTP) ELISA Kit (Catalog Number. CSB-E10363h). The concentration of ICTP in the sample was calibrated. The concentration range that the device can detect was 25 ng /mL–800 ng/mL. Results: The presence of ICTP in the VCF was confirmed. The minimum concentration was 43.72 ng/mL, the maximum was 762.59, in five cases the concentration was outside the maximum scale of the device. Conclusions: ICTP was confirmed in the VCF of pregnant women before physiological delivery. Further studies are required to accurately evaluate ICTP as a marker of the processes of collagen degradation in fetal membranes in the mechanism of physiological labor and premature rupture of the membranes