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Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population

BACKGROUND: Despite being the most generalized formula in China, the Hadlock IV formula has never been examined to determine if it is suitable for Chinese newborns, nor have the factors that might affect its performance been investigated. However, previous studies have reported varying results about...

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Autores principales: Ma, Jie, Cheng, Decui, Zhang, Zhifang, Cai, Bin, Xu, Xianming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240036/
https://www.ncbi.nlm.nih.gov/pubmed/37284125
http://dx.doi.org/10.21037/qims-22-778
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author Ma, Jie
Cheng, Decui
Zhang, Zhifang
Cai, Bin
Xu, Xianming
author_facet Ma, Jie
Cheng, Decui
Zhang, Zhifang
Cai, Bin
Xu, Xianming
author_sort Ma, Jie
collection PubMed
description BACKGROUND: Despite being the most generalized formula in China, the Hadlock IV formula has never been examined to determine if it is suitable for Chinese newborns, nor have the factors that might affect its performance been investigated. However, previous studies have reported varying results about other formulas in other nationalities. This study sought to evaluate the performance of the Hadlock IV formula in estimating fetal weight (FW) in pregnant Chinese women and use ultrasound to identify the factors affecting the accuracy of estimations of newborn weight; through these means, we aimed to create a reference for predicting neonatal weight for obstetricians. METHODS: A retrospective observational study comprising data from 976 cases of live-birth singleton pregnancies at the Shanghai General Hospital was conducted. The participants’ clinical data were examined and subjected to a logistic regression analysis to identify the multitude of possible factors affecting the estimation of FW. The proportions and correlations between the accurate and inaccurate estimation groups were compared to determine the different prognosis of these 2 groups. The correlations between the accuracy of the sonographic-based fetal weight estimation (SFWE) and newborns with different weight ranges were also analyzed. RESULTS: The overall accuracy rate of the SFWE predicted by the Hadlock IV formula was 79.61%, while that of the inaccurate estimation group was only 20.39%. The incidence of spontaneous vaginal delivery (VD) was lower in the inaccurate estimation group than in the accurate estimation group (40.7% vs. 48.13%; P=0.041). In the inaccurate estimation group, 11.56% (23/199) of the participants underwent a secondary cesarean section (sCS), compared to only 6.44% (50/777) in the accurate estimation group. The low birth weight (LBW) rates and macrosomia rates were lower in the accurate estimation group than in the inaccurate estimation group, with odds ratios (ORs) of 0.483 and 0.459, respectively (P<0.05). The results indicated that the SFWE was more accurate for newborns weighing 2,500–4,000 g than those weight out of this range. In relation to macrosomia, the SFWE was likely to be underestimated, but it was usually overestimated in the LBW group. CONCLUSIONS: The overall performance of the Hadlock IV formula in predicting the birth weight of Chinese newborns remains suboptimal. Extra caution should be exercised in cases of suspected large-for-gestational age (LGA) infants, small-for-gestational age (SGA) infants, infants with macrosomia, or LBW fetuses in the Chinese population.
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spelling pubmed-102400362023-06-06 Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population Ma, Jie Cheng, Decui Zhang, Zhifang Cai, Bin Xu, Xianming Quant Imaging Med Surg Original Article BACKGROUND: Despite being the most generalized formula in China, the Hadlock IV formula has never been examined to determine if it is suitable for Chinese newborns, nor have the factors that might affect its performance been investigated. However, previous studies have reported varying results about other formulas in other nationalities. This study sought to evaluate the performance of the Hadlock IV formula in estimating fetal weight (FW) in pregnant Chinese women and use ultrasound to identify the factors affecting the accuracy of estimations of newborn weight; through these means, we aimed to create a reference for predicting neonatal weight for obstetricians. METHODS: A retrospective observational study comprising data from 976 cases of live-birth singleton pregnancies at the Shanghai General Hospital was conducted. The participants’ clinical data were examined and subjected to a logistic regression analysis to identify the multitude of possible factors affecting the estimation of FW. The proportions and correlations between the accurate and inaccurate estimation groups were compared to determine the different prognosis of these 2 groups. The correlations between the accuracy of the sonographic-based fetal weight estimation (SFWE) and newborns with different weight ranges were also analyzed. RESULTS: The overall accuracy rate of the SFWE predicted by the Hadlock IV formula was 79.61%, while that of the inaccurate estimation group was only 20.39%. The incidence of spontaneous vaginal delivery (VD) was lower in the inaccurate estimation group than in the accurate estimation group (40.7% vs. 48.13%; P=0.041). In the inaccurate estimation group, 11.56% (23/199) of the participants underwent a secondary cesarean section (sCS), compared to only 6.44% (50/777) in the accurate estimation group. The low birth weight (LBW) rates and macrosomia rates were lower in the accurate estimation group than in the inaccurate estimation group, with odds ratios (ORs) of 0.483 and 0.459, respectively (P<0.05). The results indicated that the SFWE was more accurate for newborns weighing 2,500–4,000 g than those weight out of this range. In relation to macrosomia, the SFWE was likely to be underestimated, but it was usually overestimated in the LBW group. CONCLUSIONS: The overall performance of the Hadlock IV formula in predicting the birth weight of Chinese newborns remains suboptimal. Extra caution should be exercised in cases of suspected large-for-gestational age (LGA) infants, small-for-gestational age (SGA) infants, infants with macrosomia, or LBW fetuses in the Chinese population. AME Publishing Company 2023-04-03 2023-06-01 /pmc/articles/PMC10240036/ /pubmed/37284125 http://dx.doi.org/10.21037/qims-22-778 Text en 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Ma, Jie
Cheng, Decui
Zhang, Zhifang
Cai, Bin
Xu, Xianming
Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title_full Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title_fullStr Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title_full_unstemmed Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title_short Evaluating the accuracy of sonographic fetal weight estimations using the Hadlock IV formula in a Chinese population
title_sort evaluating the accuracy of sonographic fetal weight estimations using the hadlock iv formula in a chinese population
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240036/
https://www.ncbi.nlm.nih.gov/pubmed/37284125
http://dx.doi.org/10.21037/qims-22-778
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