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Published on: October 24, 2017
First-trimester prediction of macrosomia
Leona C Y Poon1, George Karagiannis, Violeta Stratieva
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, University College Hospital, London, UK.
Fetal Diagnosis and Therapy
|August 28, 2010
Summary
First-trimester screening for aneuploidies, including nuchal translucency (NT), free beta-human chorionic gonadotrophin (β-hCG), and pregnancy-associated plasma protein-A (PAPP-A), can significantly predict macrosomia (large baby) in combination with maternal factors.
Area of Science:
- Maternal-fetal medicine
- Prenatal diagnostics
- Pregnancy screening
Background:
- Macrosomia poses risks to both mother and child during delivery.
- Current first-trimester screening methods primarily focus on aneuploidies.
- Predicting macrosomia early can inform clinical management and improve outcomes.
Purpose of the Study:
- To evaluate the predictive value of combining maternal characteristics with aneuploidy screening markers for macrosomia.
- To determine if first-trimester ultrasound (nuchal translucency) and biochemical markers (free β-hCG, PAPP-A) improve macrosomia prediction.
Main Methods:
- A retrospective analysis of 36,743 singleton pregnancies.
- Maternal characteristics, nuchal translucency (NT), free β-human chorionic gonadotrophin (β-hCG), and pregnancy-associated plasma protein-A (PAPP-A) were recorded at 11-13 weeks.
- Regression analysis was employed to assess predictive contributions.
Main Results:
- Maternal factors like weight, height, history of macrosomia, and diabetes increased risk.
- Lower risk was observed in certain racial origins, smokers, and those with chronic hypertension.
- First-trimester markers (NT, free β-hCG, PAPP-A) significantly improved macrosomia prediction accuracy when combined with maternal factors (34.4% vs. 33.1% at 10% false-positive rate).
Conclusions:
- First-trimester screening parameters, typically used for aneuploidies, are effective in predicting macrosomia.
- Combining maternal characteristics with NT, free β-hCG, and PAPP-A measurements offers a valuable tool for early macrosomia detection.
