Impact Of Obesity And Timing Of Ultrasound On Identifying Small For Gestational Age Infants
ePoster
Authors: Adam Schettler, University of Virginia Gabrielle Smith, University of Virginia Berkley Davis, UVA Rebecca Rieck, University of Virginia School of Medicine
Small for gestational age (SGA) infants suffer from increased risks of complications including neonatal hypoglycemia, meconium aspiration, hypothermia and perinatal asphyxia. Accurately identifying these infants in the antepartum setting allows for additional delivery planning to maximize support and improve outcomes. This project investigated the utility of antenatal growth scans in identification of fetuses that will be SGA at delivery. Our study found that ultrasounds identifying those fetuses with FGR (fetal growth restriction) (EFW < 10%) is highly specific (99.26%) in identifying SGA babies, and that this specificity is not impacted by maternal obesity or the trimester in which the ultrasound is performed. However, ultrasound is not a sensitive measure to identify SGA babies and antenatal scans may miss babies that are SGA, with a sensitivity of only 32.5%. Notably, when abdominal circumference < 10% was used in addition to or instead of EFW < 10% to make a FGR diagnosis, this improved the sensitivity of antenatal growth scans without significantly decreasing the specificity. These findings suggest growth ultrasounds are a powerful tool to help identify SGA infants in the antenatal period, but that additional research is needed to improve the sensitivity and identify a larger proportion of SGA infants.