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Int J Gynaecol Obstet. 2019 Jan;144(1):9-15. doi: 10.1002/ijgo.12686. Epub 2018 Oct 19.

Quantifying bias between reported last menstrual period and ultrasonography estimates of gestational age in Lusaka, Zambia.

Author information

1
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
2
Women and Newborn Hospital, University Teaching Hospital, Lusaka, Zambia.
3
Department of Obstetrics and Gynecology, University of Zambia School of Medicine, Lusaka, Zambia.
4
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Abstract

OBJECTIVE:

To quantify differences in assessing preterm delivery when calculating gestational age from last menstrual period (LMP) versus ultrasonography biometry.

METHODS:

The Zambian Preterm Birth Prevention Study is an ongoing prospective cohort study that commenced enrolment in August 2015 at Women and Newborn Hospital of University Teaching Hospital in Lusaka, Zambia. Women at less than 20 weeks of pregnancy who were enrolled between August 17, 2015, and August 31, 2017, and underwent ultrasonography examination were included in the present analysis. The primary outcome was the difference between ultrasonography- and LMP-based estimated gestational age. Associations between baseline predictors and outcomes were assessed using simple regression. The proportion of preterm deliveries using LMP- and ultrasonography-derived gestational dating was calculated using Kaplan-Meier analysis.

RESULTS:

The analysis included 942 women. The discrepancy between estimating gestational age using ultrasonography and LMP increased with greater gestational age at presentation and among patients with no history of preterm delivery. In a Kaplan-Meier analysis of 692 deliveries, 140 (20.2%, 95% confidence interval [CI] 17.7-23.0) and 79 (11.4%, 95% CI 9.6-13.6) deliveries were classified as preterm by LMP and ultrasonography estimates, respectively.

CONCLUSION:

Taking ultrasonography as a standard, a bias was observed in LMP-based gestational age estimates, which increased with advancing gestation at presentation. This resulted in misclassification of term deliveries as preterm.

KEYWORDS:

Gestational age; Gestational age estimation; Last menstrual period; Preterm birth; Ultrasonography; Zambia

PMID:
30267538
PMCID:
PMC6283668
[Available on 2020-01-01]
DOI:
10.1002/ijgo.12686
[Indexed for MEDLINE]

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