Serial plotting of symphysis-fundal height and estimated fetal weight to improve the antenatal detection of infants small for gestational age: A cluster randomised trial.
antenatal detection
fetal growth restriction
small for gestational age
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
09
11
2022
received:
25
07
2022
accepted:
21
11
2022
medline:
9
5
2023
pubmed:
20
1
2023
entrez:
19
1
2023
Statut:
ppublish
Résumé
To assess whether standardised longitudinal reporting of growth monitoring information improves antenatal detection of infants who are small for gestational age (SGA), compared with usual care. Cluster-randomised controlled trial. Sixteen French level-3 units in 2018-2019. Singleton pregnancies. The intervention consisted of the serial plotting of symphysis-fundal height (SFH) and estimated fetal weight (EFW) measurements on customised growth charts using a software program, compared with standard antenatal care. We estimated relative risks (RR) adjusted for known risk factors for fetal growth restriction (FGR). The primary outcome was antenatal detection of FGR among SGA births (with birthweights below the tenth centile of French customised curves), defined as the mention of suspected FGR in medical records and either referral ultrasounds for growth monitoring or indicated delivery for FGR. Secondary outcomes were false-positive rates, mode of delivery, perinatal morbidity and mortality, and number of antenatal visits and ultrasounds. In total, seven intervention clusters (n = 4349) and eight control clusters (n = 4943) were analysed, after the exclusion of one intervention centre for a major deviation in protocol. SGA births represented 613 (14.1%) and 626 (12.7%) of all births, respectively. The rates of antenatal detection of FGR among SGA births were 40.0% in the intervention arm versus 37.1% in the control arm (crude RR 1.08, 95% CI 0.87-1.34; adj RR 1.09, 95% CI 0.88-1.35). No benefits of the intervention were detected in the analyses of secondary outcomes. Serial plotting of SFH and EFW measurements on customised growth charts did not improve the antenatal detection of FGR among SGA births.
Identifiants
pubmed: 36655486
doi: 10.1111/1471-0528.17399
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
729-739Subventions
Organisme : Ministère des Affaires Sociales et de la Santé - National Program for Hospital Clinical Research
ID : PHRC-N-14-0442
Investigateurs
Tiphaine Barjat
(T)
Florence Bretelle
(F)
Véronique Debarge
(V)
Gilles Grangé
(G)
Benoist Guillaume
(B)
Hélène Heckenroth
(H)
Pascale Hoffmann
(P)
Laurent Mandelbrot
(L)
Franck Perrotin
(F)
Patrick Rozenberg
(P)
Nicolas Sananes
(N)
Thomas Schmitz
(T)
Marie-Victoire Sénat
(MV)
Loïc Sentilhes
(L)
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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