Assessment of Antepartum Fetal Growth by Customized “GROW” Curves Versus Noncustomized Growth Curves in Correlation with Neonatal Growth Pattern

Abstract

Objective

To study the antepartum fetal growth between customized “GROW” curves and noncustomized growth curves with neonatal growth pattern.

Method

Fetal growth scans are performed between 30 and 35 weeks to singleton mother. Estimated fetal weights (EFWs) were determined using ultrasound variables (biparietal diameter, head circumference, abdominal circumference, and femur length). This EFW is plotted on SONOCARE software [noncustomized growth curves developed by Medialogic solutions (P) Ltd., Chennai, India] and customized “GROW” curves to determine the type of antenatal fetal growth as AGA, small for gestational age (SGA), or large for gestational age (LGA). The fetuses were followed longitudinally till birth, and the newborns’ growth patterns were determined according to birth weight at the gestational age of delivery (<10th percentile for gestational age as SGA and >90th percentile as LGA) and compared to antenatal prediction of fetal growth patterns determined by noncustomized growth curves and customized “GROW” curves.

Results

According to noncustomized growth curve at antenatal period, 93 % fetuses are AGA; 5.6 % are LGA, and 1 % are SGA. According to customized GROW curves, when the same EFW is plotted on GROW curves, 83 % are found to be AGA, 6.8 % LGA, and 10 % SGA. At postnatal period, according to newborn growth curve, 87.8 % are AGA, 8.8 % LGA, 3.4 % SGA. Sensitivity of customized “GROW” curves is more than that of noncustomized growth curves (45.45 vs. 18.18 %) for detection of SGA fetus.

Conclusion

Antenatal predictions of SGA baby by ultrasonography can be almost doubled with customized “GROW” curves than noncustomized growth curves. Customized GROW curves also better predict perinatal morbidities like neonatal jaundice and NICU admission. Antenatal serial fetal growth monitoring should be done with customized GROW curves.