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Impact of maternal body mass index on the accuracy of third trimester sonographic estimation of fetal weight

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

To Determine whether maternal body mass index (BMI) can affect the accuracy of sonographic estimation of fetal weight (EFW) in the third trimester when compared to neonatal birthweight (BW).

Methods

Secondary analysis from our original prospective cohort of pregnant women beyond 34 weeks, distributed in 4 groups according to their BMI: normal, overweight, obese and morbid obese. Fetal biometry and fluid measurements were obtained by two experienced sonographers, blinded for patient’s clinical information and to each other’s measurements. Average EFW and neonatal BW were converted into gestational-specific Z-scores. Interobserver correlation coefficient (ICC) and Cronbach's reliability coefficient (CRC) were calculated. Bland–Altman (BA) plots were constructed to assess the level of accuracy.

Results

100 women were enrolled (800 measurements obtained by 17 sonographers): 17 had normal BMI (17%), 27 were overweight (27%), 29 were obese (29%) and 27 were morbidly obese (27%). There was no statistical difference for GA at delivery (p = 0.74), EFW (p = 0.05) or BW (p = 0.09) between groups (Table 1). Mean Z-score for EFW was − 0.17 (SD 0.81) and for neonatal BW was − 0.25 (SD 0.74). ICC was 0.69 (95% CI 0.57, 0.78) and CRC was 0.82. Mean Z-score difference was small (Table 2). When stratifying according to BMI categories, the ICC ranged from 0.49 to 0.76. Reliability indices ranged from 0.66 to 0.86. The Z-scores’ differences were overall small with no statistical difference (Table 3). BA showed evenly distributed interobserver differences (Fig. 1).

Conclusions

When performed by trained sonographers, fetal weight estimation in the third trimester is accurate when compared to neonatal birthweight at increasing BMI categories.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. EVMS Salaried Faculty, Maternal Fetal Medicine/OBGYN, 825 Fairfax Avenue Suite 555, Norfolk, VA, 23455, USA

    Juliana Gevaerd Martins, Tetsuya Kawakita, Dana Baraki, Elena Sinkovskaya & Alfred Abuhamad

  2. University of Virginia Maternal Fetal Medicine Fellow (PGY-5), Charlottesville, USA

    Priyanka Jain

  3. University of Virginia OBGYN Resident (PGY-3), Charlottesville, USA

    Margot Gurganus

  4. UTMB OBGYN Resident (PGY-1), Galveston, USA

    Carole Barake

Authors
  1. Juliana Gevaerd Martins
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  2. Tetsuya Kawakita
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  3. Priyanka Jain
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  4. Margot Gurganus
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  5. Dana Baraki
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  6. Carole Barake
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  7. Elena Sinkovskaya
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  8. Alfred Abuhamad
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Contributions

JGM: project development, data analysis, data collection, and manuscript writing. TK: data analysis and manuscript review. PJ: data collection. MG: data collection. DB: data collection. CB: data collection and manuscript writing. ES: project development and manuscript review. AA: project development, data analysis, and manuscript review.

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Correspondence to Juliana Gevaerd Martins.

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Gevaerd Martins, J., Kawakita, T., Jain, P. et al. Impact of maternal body mass index on the accuracy of third trimester sonographic estimation of fetal weight. Arch Gynecol Obstet 307, 395–400 (2023). https://doi.org/10.1007/s00404-022-06495-3

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  • DOI: https://doi.org/10.1007/s00404-022-06495-3

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