“Fetal Growth Charts”: Comparison of Cross-Sectional Ultrasound Examinations with Birth Weight

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Abstract
We examined the hypothesis that fetal growth curves derived from birth weight data deviate significantly from growth curves generated from cross-sectional ultrasound estimated fetal weight. Fetal growth curves created from birth weight data were compared with growth curves generated from ultrasound examinations collected cross-sectionally (350 observations each). Groups were distributed by gestational age between 26 and 39 weeks gestation (25 observations per week). Ultrasound examinations were performed for size/dates discrepancy. Menstrual age was confirmed by ultrasound in each case. One hundred ultrasound examinations performed for size/dates discrepancy (with dating confirmed) were prospectively evaluated to compare the distribution of fetal weight percentile between the two charts. Regression lines for the growth curves were significantly different (P < 0.001). For each gestational age between 26 and 35 weeks, the ultrasound estimated fetal weights demonstrated a higher mean fetal weight (P < 0.05). Prospectively, the mean percentile of fetal weight for birth weight derived growth charts was 65% compared to 45% for the ultrasound defined (P < 0.001). For preterm infants (<35 weeks) the estimation of percentile rank for growth is different between birth weight and ultrasound derived growth curves. Sonographically derived “fetal growth charts” should provide an improved standard when characterizing ultrasound estimates of fetal weight.

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