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KMID : 1143220210640030248
Obstetrics & Gynecology Science
2021 Volume.64 No. 3 p.248 ~ p.256
Detection of small for gestational age in preterm prelabor rupture of membranes by Hadlock versus the Fetal Medicine Foundation growth charts
Duncan Jose

Leavitt Karla
Duncan Kristin
Vilchez Gustavo
Abstract
Objective: The primary outcome was to compare the diagnostic accuracy of neonatal small for gestational age (SGA) by the Hadlock and Fetal Medicine Foundation (FMF) charts in our cohort, followed by the ability to predict composite severe neonatal outcomes (SNO) in pregnancies with preterm prelabor rupture of membranes (PPROM).

Methods: This study was a secondary analysis of a prospective cohort of pregnancies with PPROM from 2015 to 2018, from 23 to 36 completed weeks of gestation. Sensitivity, specificity, and positive and negative predictive values for the primary and secondary outcomes of the Hadlock and FMF fetal charts were calculated. The discriminatory ability of each chart was compared using the area under the receiver¡¯s operating curves of clinical characteristics.

Results: Of the 106 women who met the inclusion criteria, 48 (45%) were screened positive using the FMF fetal growth chart and 22 (21%) were screened positive using the Hadlock chart. SGA was diagnosed in 12 infants (11%). Both fetal growth charts had comparable diagnostic accuracies and were statistically significant predictors of SGA (Hadlock: area under the receiver operating characteristic curves [AUC], 0.76, risk ratio [RR], 7.6, 95% confidence interval [CI], 2.5-23; and FMF: AUC, 0.76 RR, 13.3 95%CI 1.8-99.3). Both growth standards were poor predictors of SNO.

Conclusion: The Hadlock and FMF fetal growth charts have a similar accuracy to predict SGA in pregnancies complicated by PPROM. The FMF fetal growth chart may result in a 2-fold increase in positive screens, potentially increasing fetal surveillance.
KEYWORD
Fetal growth restriction, Preterm prelabor rupture of membranes
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