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Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study

OBJECTIVES: To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates. METHODS: A cohort study of 8,551 singleton pregnancies w...

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Autores principales: Näslund Thagaard, Ida, Krebs, Lone, Lausten-Thomsen, Ulrik, Olesen Larsen, Severin, Holm, Jens-Christian, Christiansen, Michael, Larsen, Torben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711898/
https://www.ncbi.nlm.nih.gov/pubmed/26760299
http://dx.doi.org/10.1371/journal.pone.0147109
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author Näslund Thagaard, Ida
Krebs, Lone
Lausten-Thomsen, Ulrik
Olesen Larsen, Severin
Holm, Jens-Christian
Christiansen, Michael
Larsen, Torben
author_facet Näslund Thagaard, Ida
Krebs, Lone
Lausten-Thomsen, Ulrik
Olesen Larsen, Severin
Holm, Jens-Christian
Christiansen, Michael
Larsen, Torben
author_sort Näslund Thagaard, Ida
collection PubMed
description OBJECTIVES: To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates. METHODS: A cohort study of 8,551 singleton pregnancies with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1(st) trimester), BPD (2(nd) trimester), and head circumference and compared mean and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods. RESULTS: The change from use of second to first trimester measurements for dating was associated with a significant increase in the rate of post-term deliveries from 2.1–2.9% and a significant decrease in the rate of pre-term deliveries from 5.4–4.6% caused by systematic discrepancies. Thereby 25.1% would pass 41 weeks when GA is defined by CRL and 17.3% when BPD (2(nd) trimester) is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1–1.4%, when first compared to second trimester dating was used. CONCLUSIONS: Systematic discrepancies were identified when biometric formulas were used to determine duration of pregnancy. This should be corrected in clinical practice to avoid an overestimation of post-term birth and unnecessary inductions when first trimester formulas are used.
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spelling pubmed-47118982016-01-26 Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study Näslund Thagaard, Ida Krebs, Lone Lausten-Thomsen, Ulrik Olesen Larsen, Severin Holm, Jens-Christian Christiansen, Michael Larsen, Torben PLoS One Research Article OBJECTIVES: To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates. METHODS: A cohort study of 8,551 singleton pregnancies with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1(st) trimester), BPD (2(nd) trimester), and head circumference and compared mean and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods. RESULTS: The change from use of second to first trimester measurements for dating was associated with a significant increase in the rate of post-term deliveries from 2.1–2.9% and a significant decrease in the rate of pre-term deliveries from 5.4–4.6% caused by systematic discrepancies. Thereby 25.1% would pass 41 weeks when GA is defined by CRL and 17.3% when BPD (2(nd) trimester) is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1–1.4%, when first compared to second trimester dating was used. CONCLUSIONS: Systematic discrepancies were identified when biometric formulas were used to determine duration of pregnancy. This should be corrected in clinical practice to avoid an overestimation of post-term birth and unnecessary inductions when first trimester formulas are used. Public Library of Science 2016-01-13 /pmc/articles/PMC4711898/ /pubmed/26760299 http://dx.doi.org/10.1371/journal.pone.0147109 Text en © 2016 Näslund Thagaard et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Näslund Thagaard, Ida
Krebs, Lone
Lausten-Thomsen, Ulrik
Olesen Larsen, Severin
Holm, Jens-Christian
Christiansen, Michael
Larsen, Torben
Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title_full Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title_fullStr Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title_full_unstemmed Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title_short Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study
title_sort dating of pregnancy in first versus second trimester in relation to post-term birth rate: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711898/
https://www.ncbi.nlm.nih.gov/pubmed/26760299
http://dx.doi.org/10.1371/journal.pone.0147109
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