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Published on: August 25, 2022
Postnatal Prediction of Gestational Age Using Newborn Fetal Hemoglobin Levels
Kumanan Wilson1, Steven Hawken2, Malia S Q Murphy3
1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Institute of Clinical Evaluative Sciences, uOttawa Site, Ottawa, Ontario, Canada.
Introduction:
In many parts of the developing world procurement of antenatal gestational age estimates is not possible, challenging provision of appropriate perinatal care. This study aimed to develop a model for postnatal gestational age estimation utilizing measures of the newborn hemoglobin levels and other metabolic analyte data derived from newborn blood spot samples.
Methods:
We conducted a retrospective cohort analysis of 159,215 infants born January 2012-December 2014 in Ontario, Canada. Multivariable linear and logistic regression analyses were used to evaluate the precision of developed models.
Results:
Models derived from a combination of hemoglobin ratios and birthweight were more precise at predicting gestational age (RMSE1·23weeks) than models limited to birthweight (RMSE1·34). Models including birthweight, hemoglobin, TSH and 17-OHP levels were able to accurately estimate gestational age to ±2weeks in 95·3% of the cohort and discriminate ≤34 versus >34 (c-statistic, 0·98). This model also performed well in small for gestational age infants (c-statistic, 0·998).
Discussion:
The development of a point-of-care mechanism to allow widespread implementation of postnatal gestational age prediction tools that make use of hemoglobin or non-mass spectromietry-derived metabolites could serve areas where antenatal gestational age dating is not routinely available.
