{"doi":"10.1055/s-0041-1728837","title":"Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth","abstract":"OBJECTIVE: The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction. STUDY DESIGN: We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement ≤ -3 cm at visit 3 (mean: 32.0 ± 1.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birth weight <10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was <10th percentile, the SGA screen was considered positive. If EFW was ≥10th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed. RESULTS: In a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%. CONCLUSION: An innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birth weight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA). KEY POINTS: · We have developed an innovative calculator for fundal height trajectory.. · Longitudinal fundal height improves detection of SGA.. · As a low cost screening test, the fundal height calculator may decrease costs and morbidity through better prediction of SGA..","journal":"American Journal of Perinatology","year":2021,"id":208253,"datarank":0.27416135194380303,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.06621719777581943,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.06621719777581943,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":3,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9267,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00912132"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":429837,"name":"Ana M. Ortega‐Villa","orcid":"0000-0002-5589-9557","position":1,"is_corresponding":false},{"id":524926,"name":"Sarah Pugh","orcid":"0000-0003-4347-2561","position":2,"is_corresponding":false},{"id":475277,"name":"Alaina M. Bever","orcid":"0000-0003-3004-8497","position":3,"is_corresponding":false},{"id":40933,"name":"William A. Grobman","orcid":"0000-0002-3979-0738","position":4,"is_corresponding":false},{"id":363638,"name":"Roger Newman","orcid":"0000-0002-2422-619X","position":5,"is_corresponding":false},{"id":393537,"name":"John Owen","orcid":"0000-0001-8854-2346","position":6,"is_corresponding":false},{"id":393534,"name":"Deborah A. Wing","orcid":"0000-0001-9896-442X","position":7,"is_corresponding":false},{"id":329158,"name":"Paul S. Albert","orcid":"0000-0003-1658-1068","position":8,"is_corresponding":false},{"id":271560,"name":"Katherine L. Grantz","orcid":"0000-0003-0276-8534","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-18T23:51:53.662668Z","pmid":"33940642","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}