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A discrepancy between gestational age estimated by last menstrual period and biparietal diameter may indicate an increased risk of fetal death and adverse pregnancy outcome
Author(s) -
Nguyen Tri huu,
Larsen Torben,
Engholm Gerda,
Møller Henrik
Publication year - 2000
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2000.tb11111.x
Subject(s) - medicine , obstetrics , pregnancy , gestation , gestational age , abortion , population , fetus , gynecology , genetics , environmental health , biology
Objective To determine if the discrepancy between gestational age estimated by last menstrual period and by biparietal diameter (GA LMP − GA BPD ) is associated with adverse pregnancy outcome. Design Population‐based follow up study. Population Singleton pregnancies were studied when a reliable date of last menstrual period and biparietal diameter measured between 12 and 22 weeks of gestation was available ( n = 16,469 ). Methods Logistic regression analysis and Kaplan‐Meier survival analysis were used to analyse the association between GA LMP − GA BPD and adverse pregnancy outcome. Main outcome measures Adverse outcome was defined as abortion after 12 weeks of gestation, stillbirth or postnatal death within one year of birth, delivery < 37 weeks of gestation, a birthweight < 2500 g or a sex‐specific birthweight lower than 22% below the expected. Results The risk of death was more than doubled if GA LMP − GA BPD of ≥ 8 days was compared with GA LMP − GA BPD of < 8 days (OR 2.2; 95% CI 1.6–3.1). The risk of death was a factor of 6.1 higher if GA LMP − GA BPD of ≥ 8 days was combined with increased (> 2 × multiple of median) maternal alphafetoprotein measured in the 2nd trimester. Conclusions A discrepancy between GA LMP and GA BPD generally reflects the precision of the two methods used to predict term pregnancy. However, a positive discrepancy of more than seven days, particularly with high maternal alpha‐fetoprotein, might indicate intrauterine growth retardation and an increased risk of adverse perinatal outcome.