Evidence map›Paper›PMID 33940642›Full record

ArticleAmerican journal of perinatology2023

Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth.

Katherine L Grantz, Ana M Ortega-Villa, Sarah J Pugh, Alaina Bever, William Grobman, Roger B Newman, John Owen, Deborah A Wing, Paul S Albert

Open access · greenAbstract read
In one paragraph

Article in American journal of perinatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Katherine L GrantzEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.ORCID 0000-0003-0276-8534
Ana M Ortega-VillaBiostatistics Research Branch, Division Clinical Research, National Institute of Allergy and Infectious Diseases, Fishers Lane, Rockville, Maryland.
Sarah J PughEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Alaina BeverEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
William GrobmanDepartment of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Roger B NewmanDepartment of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
John OwenDepartment of Obstetrics and Gynecology, The University of Alabama at Birmingham Center for Women's Reproductive Health, Birmingham, Alabama.
Deborah A WingDepartment of Obstetrics-Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, School of Medicine, Orange, California.
Paul S AlbertBiostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Eunice Kennedy Shriver National Institute of Child Health and Human Development · USMedical University of South Carolina · USNational Cancer Institute · USNational Institute of Allergy and Infectious Diseases · USNorthwestern University · USUniversity of Alabama at Birmingham · USUniversity of California, Irvine · US

Funding

Methods for Epidemiology StudiesZIACP010181 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI ALBERT, PAUL · 2009 to 2025
$34.8M
The National Standard for Normal Fetal GrowthZIAHD008852 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI GRANTZ, KATHERINE · 2009 to 2025
$5.6M
Intramural NIH HHS Z99 HD999999NICHD NIH HHS HHSN275200800002CNICHD NIH HHS HHSN275200800002INICHD NIH HHS HHSN275200800003CNICHD NIH HHS HHSN275200800003INICHD NIH HHS HHSN275200800012CNICHD NIH HHS HHSN275200800013CNICHD NIH HHS HHSN275200800014CNICHD NIH HHS HHSN275200800028CNICHD NIH HHS HHSN275201000009C
6 · The paper itself

Abstract

objectiveThe objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction. STUDY

designWe developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement ≤ -3 cm at visit 3 (mean: 32.0 ± 1.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birth weight <10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was <10th percentile, the SGA screen was considered positive. If EFW was ≥10th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed.

resultsIn a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%.

conclusionAn innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birth weight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA). KEY POINTS: · We have developed an innovative calculator for fundal height trajectory.. · Longitudinal fundal height improves detection of SGA.. · As a low cost screening test, the fundal height calculator may decrease costs and morbidity through better prediction of SGA..

Indexed as

Infant, Small for Gestational AgeUltrasonography, PrenatalBirth WeightCross-Sectional StudiesFemaleFetal Growth RetardationFetal WeightGestational AgeHumansInfant, NewbornPredictive Value of TestsPregnancyProspective Studies

Identifiers

PMID33940642
PMCPMC8802337
OpenAlexW3158004617

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.