Objective: In our laboratory, a decrease in fetal lung maturity (FLM) testing on amniotic fluid occurred over a 10-year period, and we desired to determine if this was a national phenomenon and, if present, ascertain possible etiologies.Study Design: Society of Maternal-Fetal Medicine fellows, both in academic centers and private practice, were surveyed with regard to current usage of FLM testing.Result: Of 680 surveys, 417 (61%) responses were returned and 60% noted a decrease in FLM testing (range of reductionFfoam stability index 65%, fluorescence polarization 35%, phosphatidyl glycerol 71%, lecithin/sphingomyelin ratio 70%). The most common reason suggested for the decline is that the tests were not needed for patient management.Conclusion: Obstetric patterns of FLM testing have declined, principally in near-term pregnancies, and this could adversely affect neonatal outcome.
We sought to determine if maternal body mass index (BMI; kg/m (2)) identifies newborns with abnormal fetal growth (small for gestational age [SGA], large for gestational age [LGA], or macrosomia) at ≥37 weeks. Singletons with reliable gestational age and without diabetes or hypertension were analyzed. Areas under the receiver-operating characteristic (AUC) curves were calculated for BMI (first visit, delivery, and the change during pregnancy) to identify abnormal growth. If the AUC was ≤0.75 then the diagnostic test was not useful. Among 3582 cohorts, SGA occurred in 10%, LGA in 9%, and 11% were macrosomic. AUC indicates that BMI at delivery is significantly better than BMI at first visit for identification of aberrant growth, but their AUCs were less than 0.75, indicating it is not a useful diagnostic test. Maternal BMIs (at first visit, delivery, or the change during pregnancy) are poor predictors of abnormal fetal growth.
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