Diagnostic accuracy of modified Hadlock formula for fetal macrosomia in women with gestational diabetes and pregnancy weight gain above recommended
Author:
Lovrić Boris1, Šijanović Siniša2, Lešin Joško3, Juras Josip3
Affiliation:
1. Department of Obstetrics and Gynecology , General Hospital “Nova Gradiška” , Nova Gradiška , Croatia 2. Department of Obstetrics and Gynecology , UHC Osijek, School of Medicine, University of Osijek , Osijek , Croatia 3. Department of Obstetrics and Gynecology , UHC Zagreb, School of Medicine, University of Zagreb , Zagreb , Croatia
Abstract
Abstract
Objectives
Women with gestational diabetes (GDM) and weight gain during pregnancy above recommended more often give birth to macrosomic children. The goal of this study was to evaluate the diagnostic accuracy of the modified formula for ultrasound assessment of fetal weight created in a pilot study using a similar specimen in comparison to the Hadlock-2 formula.
Methods
This is a prospective, cohort, applicative, observational, quantitative, and analytical study, which included 213 pregnant women with a singleton pregnancy, GDM, and pregnancy weight gain above recommended. Participants were consecutively followed in the time period between July 1st, 2016, and August 31st, 2020. Ultrasound estimations were made within three days before the delivery. Fetal weights estimated using both formulas were compared to the newborns’ weights.
Results
A total of 133 fetal weight estimations were made. In comparison to the newborns’ weight modified formula had significantly smaller deviation in weight estimation compared to the Hadlock-2 formula, higher frequency of deviation within 5% of newborns weights (78.2% [95% CI=0.74–0.83] vs. 60.2%), smaller frequency of deviations from 5 to 10% (19.5 vs. 33.8%) and above 10%, which was even more significant among macrosomic children. There were 36/50 (72%) correctly diagnosed cases of macrosomia by modified and 33/50 (66%) by Hadlock-2 formula. Area under the curve (AUC) for the modified formula was 0.854 (95% CI=0.776–0.932), and for the Hadlock-2 formula 0.824 (95% CI=0.740–0.908). The positive predictive value of the modified formula was 81.81%, the negative 97.91%.
Conclusions
In cases of greater fetal weights, the modified formula showed greater precision.
Publisher
Walter de Gruyter GmbH
Subject
Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health
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