Related Experiment Video
Updated: Aug 31, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Customized fetal weight limits for antenatal detection of fetal growth restriction
C L De Jong1, A Francis, H P Van Geijn
1Department of Obstetrics and Gynecology, University Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
Insights
Customized fetal weight percentiles accurately predict fetal growth restriction and adverse perinatal outcomes. The 10th customized percentile is a reliable clinical threshold for identifying at-risk neonates.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Neonatology
Background:
- Intrauterine growth restriction (IUGR) detection relies on accurate fetal weight estimation.
- Standard fetal weight charts may not adequately account for individual variations.
- Customized fetal growth standards offer improved prediction of adverse outcomes.
Purpose of the Study:
- To establish optimal cut-off limits for individually adjusted fetal weight standards.
- To enhance the detection of intrauterine growth restriction (IUGR).
- To correlate customized fetal weight percentiles with specific perinatal complications.
Main Methods:
- Retrospective study of 215 high-risk pregnancies.
- Serial ultrasound scans used for fetal weight estimation.
- Fetal weights adjusted for maternal and fetal characteristics (height, weight, ethnicity, parity, sex).
Main Results:
- Fetal weight below the 10th customized percentile predicted small-for-gestational age (SGA) neonates, operative delivery for fetal distress, and NICU admission.
- Optimal customized percentile for SGA prediction was the 18th (sensitivity 83%, specificity 79%).
- The 8th customized percentile was optimal for predicting operative delivery and NICU admission.
Conclusions:
- Individually adjusted fetal weight assessment via ultrasound predicts IUGR and hypoxia-related perinatal events.
- The 10th customized percentile serves as a practical clinical cut-off for identifying fetuses at risk.
- Customized standards improve the prediction of adverse perinatal outcomes compared to generic charts.
Objective:
To define cut-off limits for individually adjustable fetal weight standards for the detection of intrauterine growth restriction.
Design:
Retrospective study, with the outcome measures small-for-gestational age (SGA) birth weight, operative delivery for fetal distress, umbilical artery pH < 7.15, and admission to the neonatal intensive care unit.
Subjects And Methods:
Two hundred and fifteen women considered to be at increased risk of uteroplacental insufficiency were recruited to a study of serial ultrasound scans. Fetal weights were derived using standard formulae and, retrospectively, weight percentiles were calculated after individual adjustment for maternal height, weight in early pregnancy, ethnic group, parity and fetal sex.
Introduction:
One or more antenatal scans indicative of fetal weight below the 10th customized percentile were predictive for a SGA neonate at birth (P < 0.001), operative delivery for fetal distress (P < 0.01) and admission to neonatal intensive care (P < 0.01) but not for a low umbilical artery pH (P = 0.6). Receiver-operator curves showed the optimal customized fetal weight percentile limit for predicting an SGA neonate to be the 18th percentile (sensitivity 83%, specificity 79%, positive predictive value 63% and negative predictive value 92%). For the prediction of operative delivery for fetal distress and admission to neonatal intensive care, the optional customized cut-off value was the 8th percentile.
Conclusions:
The assessment of fetal weight using ultrasound and an individually-adjusted standard is predictive of growth restriction and perinatal events associated with hypoxia or diminished reserve. The optimal cut-off value for predicting operative delivery for fetal distress or admission to the neonatal intensive care unit suggests that the 10th customized percentile is a good limit for clinical use.
