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Updated: Jun 2, 2026
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
A customized standard of large size for gestational age to predict intrapartum morbidity
Jacob C Larkin1, Paul D Speer, Hyagriv N Simhan
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, PA, USA. larkinjc@mail.magee.edu
Objective:
The purpose of this study was to determine whether a customized standard of large-for-gestational age (LGA) identifies pregnancies with increased perinatal risk.
Study Design:
We evaluated 7510 estimates of fetal weight to generate a fetal growth curve. Next, we analyzed the gestational age at delivery, physiologic and pathological variables from 5072 pregnancies to predict birthweight, and calculated a customized ideal birthweight and cutoff for LGA. In a separate analysis of 32,271 pregnancies, rates of macrosomia-related adverse outcomes were compared in pregnancies that had been identified as LGA by a customized standard (LGA(cust)) and those pregnancies that had been identified as LGA or macrosomic by conventional standards.
Results:
LGA(cust) pregnancies carried increased risk of shoulder dystocia, third- or fourth-degree laceration, and cephalopelvic disproportion. LGA(cust) pregnancies that did not meet conventional criteria for LGA/macrosomia were at increased risk of all measured outcomes.
Conclusion:
A customized standard of LGA identifies a previously unrecognized population that is at increased risk of perinatal morbidity.
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