International Standards for Symphysis-Fundal Height Based on Serial Measurements From the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective Cohort Study in Eight Countries

Papageorghiou, Aris T.; Ohuma, Eric O; Gravett, Michael G.; Hirst, Jane E; Silveira, Mariangela F. da; Lambert, Ann; Carvalho, Maria Helena Catelli de; Jaffer, Y A; Altman, Douglas G.; Noble, J. Alison; Bertino, Enrico; Purwar, Manorama; Pang, Ruoming; Ismail, Leila Cheikh; Victora, Cesar G; Bhutta, Zulfiqar Ahmed; Kennedy, Stephen; Villar, José R.

doi:10.1097/ogx.0000000000000426

Cited by 14 publications

(22 citation statements)

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“…Three of the brain structures relate to clinical evaluation of cerebrospinal fluid, namely the PV, CM and anterior horn of the lateral ventricle (AV) 1 ; the two other structures are clinically relevant to the assessment of gyration and sulcation, namely the parieto‐occipital fissure (POF) and the SF. The international standards produced complement those published previously for early and late pregnancy dating 13,14 , fetal growth and estimated fetal weight 15,16 , symphysis–fundal height 17 , gestational weight gain 18 , neonatal size and body composition 19,20 and postnatal growth of preterm infants 21 .…”

Section: Introductionmentioning

confidence: 85%

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject

Napolitano

Molloholli

Donadono

et al. 2020

Ultrasound in Obstet & Gyne

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Previous charts of brain measures in current use are based on mostly small studies with poor methodology, and no follow up. In this international study we create standards for the size of five fetal brain structures, based on a prospective cohort of fetuses followed up into childhood demonstrating normal neuro-development. What are the clinical implications of this work? Clinical use of such objective fetal brain structure measurements may help to improve the screening and diagnostic performance of prenatal ultrasound; will allow a unified approach of fetal assessment by integrating with other standards from the same population, and will result in a common language when describing aberrations from expected norms.

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Section: Introductionmentioning

confidence: 85%

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject

Napolitano

Molloholli

Donadono

et al. 2020

Ultrasound in Obstet & Gyne

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“…Remote monitoring of fetal growth involved the introduction of self-measured symphyseal-fundal heights weekly from 24 weeks' gestation plotted on provided fetal growth charts supported by educational material, and ultrasound assessment of fetal growth was done in hospital according to national clinical care recommendations. 7,8 Women were screened regularly for gestational diabetes via an oral glucose tolerance test and if positive monitored blood glucose levels during the conventional care period; endocrinology consultations were delivered via telehealth. We col lected information on pregnancy outcomes following telehealth implementation between April 20 and July 26, 2020.…”

Section: Methodsmentioning

confidence: 99%

Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis

et al. 2021

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Background Little evidence is available on the use of telehealth for antenatal care. In response to the COVID-19 pandemic, we developed and implemented a new antenatal care schedule integrating telehealth across all models of pregnancy care. To inform this clinical initiative, we aimed to assess the effectiveness and safety of telehealth in antenatal care. MethodsWe analysed routinely collected health data on all women giving birth at Monash Health, a large health service in Victoria (Australia), using an interrupted time-series design. We assessed the impact of telehealth integration into antenatal care from March 23, 2020, across low-risk and high-risk care models. Allowing a 1-month implementation period from March 23, 2020, we compared the first 3 months of telehealth integrated care delivered between April 20 and July 26, 2020, with conventional care delivered between Jan 1, 2018, and March 22, 2020. The primary outcomes were detection and outcomes of fetal growth restriction, pre-eclampsia, and gestational diabetes. Secondary outcomes were stillbirth, neonatal intensive care unit admission, and preterm birth (birth before 37 weeks' gestation).

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“…To assign the gold standard GA, for scans with CRL between 15 and 95 mm, GA was assigned by the INTERGROWTH-21st formula. 11 For participants who had CRL >95 mm, GA was assigned by averaging the GA determined by the BPD according to the formula of Hadlock et al 12…”

Section: Ultrasonographymentioning

confidence: 99%

“…and the GA determined by FL by Papageorghiou 11. The WHO Alliance for Maternal and Newborn Health Improvement (AMANHI) GA study is a multicountry study that is one of the largest, well-dated, prospective, population-based pregnancy cohorts in low-middle income countries that included 7428 newborns from five countries in Africa and Asia.…”

mentioning

confidence: 99%

Simplified models to assess newborn gestational age in low-middle income countries: findings from a multicountry, prospective cohort study

Aftab¹,

Ahmed

Ahmed³

et al. 2021

BMJ Glob Health

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IntroductionPreterm birth is the leading cause of child mortality. This study aimed to develop and validate programmatically feasible and accurate approaches to estimate newborn gestational age (GA) in low resource settings.MethodsThe WHO Alliance for Maternal and Newborn Health Improvement (AMANHI) study recruited pregnant women from population-based cohorts in five countries (Bangladesh, Ghana, Pakistan, Tanzania and Zambia). Women <20 weeks gestation by ultrasound-based dating were enrolled. Research staff assessed newborns for: (1) anthropometry, (2) neuromuscular/physical signs and (3) feeding maturity. Machine-learning techniques were used to construct ensemble models. Diagnostic accuracy was assessed by areas under the receiver operating curve (AUC) and Bland-Altman analysis.Results7428 liveborn infants were included (n=536 preterm, <37 weeks). The Ballard examination was biased compared with ultrasound dating (mean difference: +9 days) with 95% limits of agreement (LOA) −15.3 to 33.6 days (precision ±24.5 days). A model including 10 newborn characteristics (birth weight, head circumference, chest circumference, foot length, breast bud diameter, breast development, plantar creases, skin texture, ankle dorsiflexion and infant sex) estimated GA with no bias, 95% LOA ±17.3 days and an AUC=0.88 for classifying the preterm infant. A model that included last menstrual period (LMP) with the 10 characteristics had 95% LOA ±15.7 days and high diagnostic accuracy (AUC 0.91). An alternative simpler model including birth weight and LMP had 95% LOA of ±16.7 and an AUC of 0.88.ConclusionThe best machine-learning model (10 neonatal characteristics and LMP) estimated GA within ±15.7 days of early ultrasound dating. Simpler models performed reasonably well with marginal increases in prediction error. These models hold promise for newborn GA estimation when ultrasound dating is unavailable.

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International Standards for Symphysis-Fundal Height Based on Serial Measurements From the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective Cohort Study in Eight Countries

Abstract: ObjeCtiveTo create international symphysis-fundal height standards derived from pregnancies of healthy women with good maternal and perinatal outcomes. DesignProspective longitudinal observational study.setting Eight geographically diverse urban regions in Brazil,

Cited by 14 publications

References 10 publications

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject

Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis

Simplified models to assess newborn gestational age in low-middle income countries: findings from a multicountry, prospective cohort study

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International Standards for Symphysis-Fundal Height Based on Serial Measurements From the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective Cohort Study in Eight Countries

Abstract: ObjeCtiveTo create international symphysis-fundal height standards derived from pregnancies of healthy women with good maternal and perinatal outcomes. DesignProspective longitudinal observational study.setting Eight geographically diverse urban regions in Brazil,

Cited by 14 publications

References 10 publications

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21stProject

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21stProject

Widespread implementation of a low-cost telehealth service in the delivery of antenatal care during the COVID-19 pandemic: an interrupted time-series analysis

Simplified models to assess newborn gestational age in low-middle income countries: findings from a multicountry, prospective cohort study

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International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject

International standards for fetal brain structures based on serial ultrasound measurements from Fetal Growth Longitudinal Study ofINTERGROWTH‐21^stProject