Application of new fetal growth standards in a multiethnic population

J Matern Fetal Neonatal Med. 2022 Oct;35(20):3955-3963. doi: 10.1080/14767058.2020.1844657. Epub 2020 Nov 17.

Abstract

Objectives: Ultrasound assessment of fetal growth is essential to reduce adverse pregnancy outcomes. Intergrowth-21st developed international standards. Currently, we use in France chart based on Hadlock's formula. This study aims to evaluate, the impact of switching from national curves to IG-21 curves or a combination of IG-21 with Hadlock.

Methods: The study population consisted of 3 697 singleton pregnancies with fetal biometry measured between 22 and 38 weeks of gestation. Z-scores were calculated for each biometry according to CFEF and IG-21. The estimated fetal weight and its Z-score were calculated using the Hadlock formula and IG-21 formula.

Results: We observed 21% of head circumference, 9% of abdominal circumference and 7% of femoral length below the 10th centile with Intergrowth-21. Concerning estimated fetal weight, IG-21 classified 13.8% fetuses as SGA, IG-21/Hadlock 10.8% and CFEF 16.1%. Between 36 and 38 weeks of gestation, IG-21 classified more fetuses as SGA than IG-21/Hadlock and CFEF, respectively 18%, 14.1% and 13.3%.

Conclusion: The use of IG-21 or IG-21/Hadlock in the general population would lower the number of fetuses classified as SGA except for fetuses between 36 and 38 weeks. During this period, many decisions of induced early delivery or specific management are established to prevent adverse perinatal outcome. Those results must be supplemented by a comparison to newborns' weight.

Keywords: Estimated fetal weight; Hadlock; Intergrowth-21; fetal biometry; small for gestational age.

MeSH terms

  • Biometry / methods
  • Female
  • Fetal Development
  • Fetal Growth Retardation
  • Fetal Weight*
  • Fetus
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Pregnancy
  • Ultrasonography, Prenatal* / methods