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Prenatal prediction of small- and large-for-gestational age neonates
1Department of Maternal Child Nursing, University of Illinois, Chicago 60680.
Objective:
To test the predictive accuracy of five fundal height growth curves in the identification of twin gestations and small-, appropriate-, and large-for-gestational age neonates.
Design:
Retrospective review of prenatal records.
Setting:
Perinatal clinic at a tertiary-care center.
Participants:
Five hundred seven medically indigent women.
Measures:
Fundal height measurements were tested against the limits of normal for each week of gestation on five fundal height curves. Neonates were classified as small-, appropriate-, or large-for-gestational age (based on weight for gestational age), except for twin gestations, which were classified as twins.
Results:
The accuracy of the predictions depended on which curve was used and what criteria were used to classify fundal height measurements as abnormal. Small-for-gestational age neonates (n = 40) were correctly predicted in 27.5-70% of the cases, large-for-gestational age neonates (n = 74) in 36.5-98.6% of the cases, and all four twin gestations.
Conclusions:
Clinicians should test the accuracy of any fundal height curve before using it in practice.