The relationship between estimated weight of the fetus using two ultrasound and Johnson methods with actual weight of the baby at birth in pregnant diabetic mothers

Document Type : Original Article

Authors

1 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant professor, Department of Molecular Medicine, Clinical Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Fetal birth weight, as one of the most important indicators for evaluating the health of newborns, is influenced by various factors such as maternal diabetes. Fetal weight estimating is necessary for planning the type and time of delivery. The present study was performed with aim to compare the estimated fetal weight before birth with the actual weight of the baby after birth in diabetic mothers.
Methods: This descriptive-cross-sectional study was done from April 2022 to April 2023 on 71 diabetic mothers in the obstetrics and gynecology department of Imam Reza and Qaem hospitals in Mashhad. All the characteristics of the mother were recorded in the researcher-made checklist. The fetal weight before termination of pregnancy was estimated by ultrasound and also by Johnson's clinical formula, and then the actual weight of the baby was measured after delivery. Data were analyzed by SPSS software (version 22). To compare the fetal estimated weight with the actual weight after birth, Pearson's test was used to evaluate the type of correlation (p<0.001) and Bland Altman's diagram was used to check the pattern of agreement.
Results: In the Pearson correlation analysis, there was a positive and statistically significant correlation between the estimated weight by Johnson's method and ultrasound with the actual fetal birth weight, and in the presence of different variables, this correlation was still positive and significant (r=0.9, p<0.001). In the investigation of any agreement pattern between different methods of fetal weight estimation using Bland Altman method, which was based on the distance between the upper and lower limit of agreement between different methods, it was shown that this distance between Johnson's estimated fetal weight and the actual fetal weight was 1230.44 gr, between the Ultrasound and real weight was 1111.84 gr and between ultrasound and Johnson was 1136.8 gr, which did not have an acceptable level of agreement.
Conclusion: Despite the positive and significant correlation between Johnson's clinical fetal weight estimation and ultrasound, these methods cannot be replaced for each other in estimating the fetal weight, and considering the reported difference, ultrasound estimated fetal weight compared to Johnson's method is closer to actual fetal weight.

Keywords

Main Subjects

References

  1. Lu Y, Fu X, Chen F, Wong KK. Prediction of fetal weight at varying gestational age in the absence of ultrasound examination using ensemble learning. Artificial intelligence in medicine 2020; 102:101748.
  2. Stirnemann J, Salomon LJ, Papageorghiou A. INTERGROWTH‐21st standards for Hadlock's estimation of fetal weight. Ultrasound Obstet Gynecol 2020; 56(6):946-8.
  3. Rebelo F, Carrilho TR, Canuto R, Schlussel MM, Farias DR, Ohuma EO, et al. Estimated fetal weight standards of the INTERGROWTH-21st project for the prediction of adverse outcomes: a systematic review with meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2023; 36(2):2230510.
  4. Konwar R, Basumatary B, Dutta M, Mahanta P. Accuracy of fetal weight estimation by ultrasonographic evaluation in a northeastern region of India. International Journal of Biomaterials 2021; 2021.
  5. Ashoor G, Syngelaki A, Papastefanou I, Nicolaides KH, Akolekar R. Development and validation of model for prediction of placental dysfunction‐related stillbirth from maternal factors, fetal weight and uterine artery Doppler at mid‐gestation. Ultrasound in Obstetrics & Gynecology 2022; 59(1):61-8.
  6. Ge C, Xu D, Yu P, Fang M, Guo J, Xu D, et al. P-gp expression inhibition mediates placental glucocorticoid barrier opening and fetal weight loss. BMC medicine 2021; 19:1-20.
  7. Briffa C, Stirrup O, Huddy C, Richards J, Shetty S, Reed K, et al. Twin chorionicity‐specific population birth‐weight charts adjusted for estimated fetal weight. Ultrasound in Obstetrics & Gynecology 2021; 58(3):439-49.
  8. Emanuel I, Kimpo C, Moceri V. The association of maternal growth and socio-economic measures with infant birthweight in four ethnic groups. International journal of epidemiology 2004; 33(6):1236-42.
  9. Monier I, Ego A, Benachi A, Hocquette A, Blondel B, Goffinet F, et al. Unisex vs sex-specific estimated fetal weight charts for fetal growth monitoring: a population-based study. American Journal of Obstetrics & Gynecology MFM 2022; 4(1):100527.
  10. Benson‐Cooper S, Tarr GP, Kelly J, Bergin CJ. Accuracy of ultrasound in estimating fetal weight in New Zealand. Australasian Journal of Ultrasound in Medicine 2021; 24(1):13-9.
  11. Atlass JH, Rogan S, Himes KP. Accuracy of estimated fetal weight in extremely preterm infants and the impact of prepregnancy body mass index. American Journal of Obstetrics & Gynecology MFM 2022; 4(3):100615.
  12. González González NL, González Dávila E, González Martín A, Padrón E, García Hernández JÁ. Maternal thinness and obesity and customized fetal weight charts. Fetal Diagnosis and Therapy 2021; 48(7):551-9.
  13. Aliyeva M, Aydın S. Use of ultrasound fetal shoulder soft tissue thickness measurement in estimation of fetal weight. Journal of Obstetrics and Gynaecology Research 2021; 47(5):1727-34.
  14. Workalemahu T, Rahman ML, Ouidir M, Wu J, Zhang C, Tekola-Ayele F. Associations of maternal blood pressure-raising polygenic risk scores with fetal weight. Journal of human hypertension 2022; 36(1):69-76.
  15. Shittu AS, Kuti O, Orji EO, Makinde NO, Ogunniyi SO, Ayoola OO, et al. Clinical versus sonographic estimation of foetal weight in southwest Nigeria. Journal of health, population, and nutrition 2007; 25(1):14.
  16. Lanowski JS, Lanowski G, Schippert C, Drinkut K, Hillemanns P, Staboulidou I. Ultrasound versus clinical examination to estimate fetal weight at term. Geburtshilfe und Frauenheilkunde 2017; 77(03):276-83.
  17. Weiner E, Mizrachi Y, Fainstein N, Elyashiv O, Mevorach-Zussman N, Bar J, et al. Comparison between three methods of fetal weight estimation during the active stage of labor performed by residents: a prospective cohort study. Fetal diagnosis and therapy 2017; 42(2):117-23.
  18. Husslein H, Worda C, Leipold H, Szalay S. Accuracy of fetal weight estimation in women with diet controlled gestational diabetes. Geburtshilfe und Frauenheilkunde 2012; 72(02):144-8.
  19. Naeem Z, Butt NA, Ghaffar Q, Tabbasum Q, Zafar SM, Almas H, et al. Sonographic Comparison of Estimated Fetal Weight (EFW) in Diabetic and Non-Diabetic Mothers During 3rd Trimester. Journal of Health and Medical Sciences 2019; 2(3).
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 26, Issue 10
December 2023
Pages 34-42

Files

Share

How to cite

Statistics