Volume 24, Issue 104, July - August, 2020

Prediction of macrosomia by fetal biacromial diameter among term neonates

Fatemeh Azadi¹, Masoumeh Shafaat^2♦, Maryam Moshfeghi³, Ameneh Abiri⁴, Mamak Shariat⁵, Soghra Khazardoost⁶

¹Department of Perinatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
²Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran-Iran & Department of Perinatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
³Department of endocrinology and female infertility, Reproductive Biomedicine Research Center, Royan Institute, ACECR, Tehran, Iran
⁴Department of Perinatology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
⁵Professor, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
⁶Professor, Department of Perinatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

^♦Corresponding author
Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran-Iran / Department of Perinatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

ABSTRACT

Objectives: Although clinical and ultrasonographic assessments are implemented to predict fetal macrosomia, there are still lots of controversies regarding to using different predictive parameters. The aim of present study was to compare the mean of biacromial diameters in macrosomic and non-acrosomic neonates to determine the accuracy of this predictive parameter. Methods: A multicenter, cross sectional study was carried out in two Iranian hospitals in 2019. The study population consisted of 37-42 weeks pregnant women attending in labor room for delivery. After admission, a transabdominal ultrasound examination was performed. All fetal parameters including estimated fetal weight, biparietal diameter (BPD), head circumstance, chest circumstance, abdominal circumstance (AC), mid arm diameter, transverse thoracic diameter, femur length, were measured. Fetal biacromial diameter was also determined using formula and recorded. After delivery, the neonates' birth weights were measured. Based on birth weight, neonates were divided into 2 macrosomic and non-macrosomic groups. The mean of biacromial diameter in macrosomic and non-acrosomic neonates was compared, sensitivity and specificity associated the biacromial diameter in prediction of fetal macrosomia among term neonates were also determined. Results: The mean of biacromial diameter in macrosomic group was significantly higher than counterpart group (18.72±0.94 mm vs. 15.27±1.64 mm; P= 0.0001). Based on ROC curves, Area under curve (AUC) for biacromial diameter as a significant diagnostic value for macrosomia was 0.979 (p=0.0001, 95% CI: 0.954, 1.000). AUC for abdominal circumference was also 0.857 (p=0.0001, 95% CI: 0.717, 0.998). Conclusion: biacromial diameter index with high sensitivity, specificity values and its significant correlation with birth weight could predict macrosomia. Further studies with larger sample size are strongly suggested.

Keywords: macrosomia; biacromial diameter; abdominal circumference; birth weight, sensitivity; specificity

Medical Science, 2020, 24(104), 2059-2066

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