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A first trimester prediction model for large for gestational age infants: a preliminary study
Francesca Monari1, Daniela Menichini2, Ludovica Spano' Bascio1
1Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy.
BMC Pregnancy and Childbirth
|September 25, 2021
Summary
A new prediction model using first-trimester maternal characteristics can identify pregnancies at risk for large for gestational age (LGA) infants. This tool aids in early identification for timely interventions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Clinical Prediction Modeling
Background:
- Large for gestational age (LGA) infants face increased risks of adverse perinatal outcomes.
- Early identification of LGA risk is crucial for targeted interventions.
- First-trimester maternal characteristics offer a window for risk assessment.
Purpose of the Study:
- To develop a multivariable prediction model for LGA risk.
- To utilize biochemical, biophysical, anamnestic, and clinical data from the first trimester.
- To provide an early screening tool for identifying pregnancies at high risk for LGA.
Main Methods:
- Prospective study including 503 singleton pregnancies.
- Data collected during first-trimester aneuploidy screening.
- Multivariable logistic regression analysis to develop the prediction model.
Main Results:
- The final model included multiparity, pre-pregnancy BMI, and PAPP-A MoM.
- The model demonstrated satisfactory predictive accuracy with an ROC curve of 70.5%.
- A specific cut-off identified a 20.1% probability of LGA with 55.2% sensitivity and 79.0% specificity.
Conclusions:
- A first-trimester model incorporating multiparity, pre-pregnancy BMI, and PAPP-A effectively predicts LGA risk.
- This predictive tool can identify women requiring targeted interventions early in pregnancy.
- The model offers a promising approach for proactive management of LGA pregnancies.
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