OBJECTIVE:

To compare the performance of four fetal growth charts for the prediction of adverse perinatal outcomes.

MATERIALS AND METHODS:

Retrolective cohort study performed at the Maternal-Fetal Medicine Department of the National Institute of Perinatology (INPer) of pregnancies attended between May 2017 to January 2019. Four fetal growth charts (Hadlock, INTERGROWTH-21st, Fetal Medicine Foundation and Fetal Medicine Foundation Barcelona) were used for the evaluation of the last obstetric ultrasound of a retrolective cohort. Performance and relative risk ratios for adverse perinatal outcomes given by the less than 10th and greater than 90th percentiles of estimated fetal weight according to each table were analyzed and the adjusted sensitivity of each table for a false-positive rate of 10% was calculated.

RESULTS:

1053 patients were identified; the median interval between the last ultrasonographic evaluation and birth was 21 days +/- 12. The median number of weeks of gestation at birth was 38.2. Estimated fetal weight less than the 10th percentile, according to all four charts, was associated with an increased risk of composite adverse perinatal outcome. The association was greatest with the Barcelona Fetal Medicine Foundation chart (RR 1.69; 95%CI: 1.41, 2.02) and INTERGROWTH-21st (RR 1.59; 95%CI: 1.32, 1.92). Sensitivity in the small for gestational age group for adverse perinatal outcome had wide variation between the charts (20.5% INTERGROWTH-21st - 32.6% Fetal Medicine Foundation), given primarily by the difference in false positive rate.

CONCLUSION:

In the study population, the predictive performance of the fetal growth charts by the Barcelona Fetal Medicine Foundation and INTEGROWTH-21st was superior.

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