ArticleActa obstetricia et gynecologica Scandinavica2026
Population-specific validation of fetal weight formulas: Evidence from a multicenter near-delivery cohort.
Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAccurate ultrasound estimated fetal weight (EFW) supports key perinatal decisions. This study aimed to compare the accuracy of a population-specific formula with that of a widely used global model in pregnancies examined near delivery. MATERIAL AND
methodsThis was a secondary analysis of a prospective Japanese cohort study to develop a new fetal ultrasound biometry reference chart. Fetal ultrasound measurements were obtained by Japan Society of Ultrasonics in Medicine-certified sonographers or under their supervision and submitted to the coordinating center, where EFW was calculated using the Shinozuka and Hadlock-3 formulas. Analyses were restricted to cases with EFW available from both formulas. The primary analysis included examinations within 7 days before delivery; a sensitivity analysis restricted the interval to ≤3 days. A subgroup analysis was performed in fetuses classified as small for gestational age (SGA).
resultsIn the primary analysis (n = 310), the median signed error was -75.8 g for Shinozuka and -223.3 g for Hadlock-3 (Wilcoxon p < 0.001). The median absolute percentage signed error was 4.81% for Shinozuka and 7.93% for Hadlock-3 (Wilcoxon p < 0.001). The proportion within ±10% of BW was 83.9% with Shinozuka versus 61.6% with Hadlock-3 (McNemar p < 0.001). In the sensitivity analysis (n = 176), similar findings were observed. In the SGA subgroup (n = 40), the signed error and absolute percentage error were significantly lower with the Shinozuka formula than with Hadlock-3.
conclusionsIn this multicenter cohort examined near delivery, the population-specific Shinozuka formula produced EFW closer to BW and a higher proportion within ±10% than Hadlock-3, which showed greater systematic underestimation. These findings support the use of locally validated, population-specific EFW formulas when available, particularly for clinical decision-making near delivery.
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