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Author Notes:

Correspondence: P.H.Nguyen@cgiar.org.

NPD contributed to developing the research question, conducting the statistical analysis, and drafting and revising the manuscript.

PHN is a co-investigator of the study and contributed to writing the proposal, developing the research questions and study design, overseeing data collection, advising on the statistical analysis of data, providing inputs/ comments for the manuscript.

HP a day to-day project field director, participated in field supervision, carried out data collection and provided inputs for manuscript.

SN participated in field organization and provided inputs for manuscripts.

LN contributed to study design, and provided inputs/ comments for the manuscript.

RM a co-investigator of the study and contributed to developing the research questions and study design, and provided inputs/ comments for the manuscript.

UR is the principal investigator of the study and contributed to writing proposal, developing the research questions and study design, overseeing the study, and providing comments/ inputs for manuscript.

The authors gratefully acknowledge the field staff and participants of the PRECONCEPT study. The authors thank O. Yaw Addo, MS, PhD for his statistical assistance. The authors also thank the Reviewers for their thoughtful feedback to help improve the manuscript.

The authors declare that they have no competing interests.

Subject:

Research Funding:

Funding for this research was provided by the Mathile Institute for the Advancement of Human Nutrition and the Micronutrient Initiative. Mr. Deputy was supported in part by U.S. National Institutes of Health Training grant T32-DK007734.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Obstetrics & Gynecology
  • Gestational age
  • Last menstrual period
  • Ultrasound
  • Neonatal examination
  • Vietnam

Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam

Tools:

Journal Title:

BMC Pregnancy and Childbirth

Volume:

Volume 17, Number 1

Publisher:

, Pages 25-25

Type of Work:

Article | Final Publisher PDF

Abstract:

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.

Copyright information:

© 2017 The Author(s). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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