Correlation of Fractional Limb Volume Measurements with Neonatal Morphometric Indices

Abstract

<b><i>Objectives:</i></b> Fractional thigh volume (TVol) and fractional arm volume (AVol) measurements by three-dimensional (3D) ultrasound can reveal valuable information on fetal soft tissue development. However, it is not clear whether TVol or AVol provides better estimates of fetal body proportion and adiposity, independent of routine two-dimensional (2D) ultrasound biometry. The primary objective of the current study was to determine the correlations between fractional limb volumes (FLVs) and neonatal anthropometric parameters. <b><i>Design:</i></b> In this cross-sectional study, fetal FLVs were obtained within 24 h before term delivery from 40 medically and obstetrically uncomplicated pregnancies scheduled for elective cesarean section. TVol and AVol were determined using offline software. Postnatal morphometric data including birth weight; crown-heel, arm, and leg lengths; head, abdominal, mid-thigh, and mid-arm circumferences; and anterior thigh, biceps, and subscapular skinfold thicknesses were obtained. Pearson and partial correlation analyses were used to determine the relationships across antenatal volume calculations and neonatal indices. Correlation coefficients (<i>r</i>) were calculated. <b><i>Results:</i></b> Mean maternal age, BMI, and parity were 29.1 ± 5.4 years, 29.7 ± 3.5 kg/m², and 1.0 ± 1.3, respectively. AVol showed moderate correlations with most of the neonatal parameters, including mid-thigh circumference (<i>r</i> = 0.683), mid-arm circumference (<i>r</i> = 0.627), birth weight (<i>r</i> = 0.583), head circumference (HC, <i>r</i> = 0.560), and abdominal circumference (<i>r</i> = 0.542). However, TVol was weakly related to only some of the indices. After controlling for gestational age, maternal age, BMI, parity, and 2D ultrasound biometry, TVol was no longer associated with any of the parameters, while AVol was independently correlated with mid-thigh (<i>r</i> = 0.724) and mid-arm circumference (<i>r</i> = 0.560), birth weight (<i>r</i> = 0.502), ponderal index (<i>r</i> = 0.402), HC (<i>r</i> = 0.382), biceps (<i>r</i> = 0.384), and subscapular skinfold thickness (<i>r</i> = 0.350). <b><i>Limitations:</i></b> The current design includes limited number of pregnancies with only scheduled cesarean deliveries. Neonatal percent body fat was not calculated, and air-displacement plethysmography was not used to assess neonatal body composition. The study population was Caucasian with a relatively high maternal BMI, which may limit extrapolation of the results to other settings. <b><i>Conclusions:</i></b> AVoL measurements by 3D ultrasound before delivery are significantly correlated with most of the neonatal morphometric indices, independent of maternal characteristics and 2D biometric parameters. AVol may have advantages over TVol for assessing limb soft tissue development in term fetuses. Future research can focus on feasibility and predictive ability of AVol measurements in prospective studies that include serial biometry over time.