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J Reprod Med. 2003 May;48(5):339-42.

Detecting fetal macrosomia with abdominal circumference alone.

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1
Division of Maternal-Fetal Medicine, Spartanburg Regional Medical Center, Spartanburg, South Carolina, USA.

Abstract

OBJECTIVE:

To determine if abdominal circumference (AC) can identify macrosomia (> or = 4,000 g) at or beyond 37 weeks.

STUDY DESIGN:

Prospectively, parturients at term admitted for delivery underwent sonographic mensuration of AC. A receiver-operating characteristic (ROC) curve was constructed to determine if AC can differentiate between normal (birth weight < 3,999 g) and macrosomia. A likelihood ratio was calculated. P < .05 was considered significant.

RESULTS:

The mean gestational age of the 256 subjects was 39.1 +/- 1.5 weeks, and the prevalence of macrosomia was 8.2% (21/256). Inspection of the ROC curve indicated that AC > or = 350 mm can identify macrosomic fetuses. The area under the ROC curve (0.79 +/- 0.04 for macrosomia) was significantly different than the area under the nondiagnostic line (P < .005). The likelihood ratio for AC to detect macrosomia was 2.9 (95% confidence interval, 2.1-4.0). Based on the proportion of macrosomia in our population, we would require over 1,000,000 newborns for a macrosomia analysis to obtain narrow confidence intervals around a clinically useful likelihood ratio.

CONCLUSION:

Using the guidelines proposed by the Evidence-Based Medicine Working Group, AC is slightly useful in detecting macrosomia among term parturients.

PMID:
12815906
[Indexed for MEDLINE]
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