Document Detail


Isolated short femur length on second-trimester sonography: a marker for fetal growth restriction and other adverse perinatal outcomes.
MedLine Citation:
PMID:  23197546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To estimate the association between isolated second-trimester short femur length and fetal growth restriction as well as other adverse perinatal outcomes.
METHODS: We conducted a retrospective cohort study of patients with singleton gestations presenting for sonography between 16 and 24 weeks' gestation from 1990 to 2009. Cases of aneuploidy, skeletal dysplasia, and major anomalies were excluded. Short femur length was defined as length below the 10th percentile for gestational age and was considered isolated when both the estimated fetal weight and abdominal circumference were above the 10th percentile for gestational age. Isolated short femur length below the 5th percentile was also evaluated. The primary outcome was fetal growth restriction, defined as birth weight below the 10th percentile. Secondary outcomes included preeclampsia and preterm birth before 37 and 34 weeks. Univariable and multivariable logistic regression analyses were used to estimate the risk of these outcomes in fetuses with isolated short femur length.
RESULTS: Of 73,884 patients, 569 (0.8%) had a fetus with a femur length below the 10th percentile, of which 268 (47.1%) were isolated; 210 patients (0.3%) had a fetus with a femur length below the 5th percentile, of which 34 (16.2%) were isolated. Isolated short femur lengths below the 10th and 5th percentiles were associated with an increased risk of fetal growth restriction (<10th: adjusted odds ratio [aOR], 3.4; 95% confidence interval [CI], 2.4-4.6; <5th: aOR, 4.6; 95% CI, 2.0-10.7) and also with an increased risk of preterm birth before 37 and 34 weeks. There was no significant association between isolated short femur length and preeclampsia.
CONCLUSIONS: Isolated short femur length on second-trimester sonography is associated with a greater than 3-fold increased risk of fetal growth restriction and an increased risk of preterm birth. Serial growth assessment may be warranted in these cases.
Authors:
Katherine R Goetzinger; Alison G Cahill; George A Macones; Anthony O Odibo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  31     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-05-13     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1935-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Female
Femur / abnormalities*,  ultrasonography*
Fetal Growth Retardation / ultrasonography*
Humans
Infant, Newborn
Pregnancy
Pregnancy Trimester, Second
Premature Birth / epidemiology
Retrospective Studies
Ultrasonography, Prenatal*
Grant Support
ID/Acronym/Agency:
5 T32 HD055172/HD/NICHD NIH HHS; T32 HD055172/HD/NICHD NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 TR000448/TR/NCATS NIH HHS
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