Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam
Background Accurate 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 w...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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Springer
2017
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| Online Access: | https://hdl.handle.net/10568/148587 |
| _version_ | 1855532922706067456 |
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| author | Deputy, Nicholas P. Nguyen, Phuong Hong Pham, Hoa Nguyen, Son Neufeld, Lynnette M. Martorell, Reynaldo Ramakrishnan, Usha |
| author_browse | Deputy, Nicholas P. Martorell, Reynaldo Neufeld, Lynnette M. Nguyen, Phuong Hong Nguyen, Son Pham, Hoa Ramakrishnan, Usha |
| author_facet | Deputy, Nicholas P. Nguyen, Phuong Hong Pham, Hoa Nguyen, Son Neufeld, Lynnette M. Martorell, Reynaldo Ramakrishnan, Usha |
| author_sort | Deputy, Nicholas P. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background Accurate 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. Methods Data 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. Results The 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). Conclusion In 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. |
| format | Journal Article |
| id | CGSpace148587 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1485872025-12-08T10:29:22Z Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam Deputy, Nicholas P. Nguyen, Phuong Hong Pham, Hoa Nguyen, Son Neufeld, Lynnette M. Martorell, Reynaldo Ramakrishnan, Usha gestation period pregnancy health ultrasound mothers women Background Accurate 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. Methods Data 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. Results The 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). Conclusion In 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. 2017 2024-06-21T09:25:08Z 2024-06-21T09:25:08Z Journal Article https://hdl.handle.net/10568/148587 en http://set.odi.org/wp-content/uploads/2017/02/SET-essays.pdf Open Access application/pdf Springer Deputy, Nicholas P.; Nguyen, Phuong H.; Pham, Hoa; Nguyen, Son; Neufeld, Lynnette; Martorell, Reynaldo; and Ramakrishnan, Usha. Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam. BMC Pregnancy and Childbirth 17 (25). https://doi.org/10.1186/s12884-016-1192-5 |
| spellingShingle | gestation period pregnancy health ultrasound mothers women Deputy, Nicholas P. Nguyen, Phuong Hong Pham, Hoa Nguyen, Son Neufeld, Lynnette M. Martorell, Reynaldo Ramakrishnan, Usha Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title | Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title_full | Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title_fullStr | Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title_full_unstemmed | Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title_short | Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam |
| title_sort | validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in vietnam |
| topic | gestation period pregnancy health ultrasound mothers women |
| url | https://hdl.handle.net/10568/148587 |
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