Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam

BMC Pregnancy and Childbirth

Research Article

Lynnette Neufeld¹  Nicholas P. Deputy²  Reynaldo Martorell³  Usha Ramakrishnan³  Hoa Pham⁴  Son Nguyen⁴  Phuong H. Nguyen⁵ 

[1] Global Alliance for Improved Nutrition, Geneva, Switzerland;Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA;Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA;Hubert Department of Global Health, Emory University, Atlanta GA, USA;Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam;Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam;International Food Policy Research Institute, Washington DC, USA;

关键词: Gestational age;    Last menstrual period;    Ultrasound;    Neonatal examination;    Vietnam;   

DOI  :  10.1186/s12884-016-1192-5

 received in 2015-10-25, accepted in 2016-12-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAccurate estimation of gestational age is important for both clinical and public health purposes. Estimates of gestational age using fetal ultrasound measurements are considered most accurate but are frequently unavailable in low- and middle-income countries. The objective of this study was to assess the validity of last menstrual period and Farr neonatal examination estimates of gestational age, compared to ultrasound estimates, in a large cohort of women in Vietnam.MethodsData for this analysis come from a randomized, placebo-controlled micronutrient supplementation trial in Vietnam. We analyzed 912 women with ultrasound and prospectively-collected last menstrual period estimates of gestational age and 685 women with ultrasound and Farr estimates of gestational age. We used the Wilcoxon signed rank sum test to assess differences in gestational age estimated by last menstrual period or Farr examination compared to ultrasound and computed the intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) to quantify agreement between methods. We computed the Kappa coefficient (κ) to quantify agreement in preterm, term and post-term classification.ResultsThe median gestational age estimated by ultrasound was 273.9 days. Gestational age was slightly overestimated by last menstrual period (median 276.0 days, P < 0.001) and more greatly overestimated by Farr examination (median 286.7 days, P < 0.001). Gestational age estimates by last menstrual period and ultrasound were moderately correlated (ICC = 0.78) and concordant (CCC = 0.63), whereas gestational age estimates by Farr examination and ultrasound were weakly correlated (ICC = 0.26) and concordant (CCC = 0.05). Last menstrual period and ultrasound estimates of gestational age were within ± 14 days for 88.4% of women; Farr and ultrasound estimates were within ± 14 days for 55.8% of women. Last menstrual period and ultrasound estimates of gestational age had higher agreement in term classification (κ = 0.41) than Farr and ultrasound (κ = 0.05).ConclusionIn this study of women in Vietnam, we found last menstrual period provided a more accurate estimate of gestational age than the Farr examination when compared to ultrasound. These findings provide useful information about the utility and accuracy of different methods to estimate gestational age and suggest last menstrual period may be preferred over Farr examination in settings where ultrasound is unavailable.Trial registrationThe trial was registered at ClinicalTrials.Gov as NCT01665378 on August 13, 2012.

【 授权许可】

CC BY   
© The Author(s). 2017