Performance of fetal ultrasound and magnetic resonance imaging in
predicting birthweight according to the test-to-delivery interval: a
cohort study
Abstract
Objective: To assess the influence of the test-to-delivery
interval (TDI) on the performance of ultrasound (US) and magnetic
resonance imaging (MRI) for predicting birthweight (BW).
Design: Secondary analysis of a prospective cohort study.
Setting: Belgium, 2016. Population: Women with
singleton pregnancy and live birth who underwent estimated fetal weight
(EFW) by US and MRI between 36 +0/7 and 36
+6/7 weeks of gestation (WG). Methods: The
study population was grouped into three groups: TDI<2 weeks
(group 1, n=313), TDI≥2 and <4 weeks (group 2, n=1440), and
TDI≥4 weeks (group 3, n=625). Main outcome measures The
correlation between EFW-US or EFW-MRI and BW as well as the performance
of both tests in predicting BW>95 th,
>90 th, <10
th, and <5 th percentiles
according to TDI. Results: There was a strong positive
correlation between MRI-EFW and BW percentiles in group 1 (R=0.934
[95%CI: 0.918-0.947]), it dropped significantly but remained
strongly positive in groups 2 and 3 (p<0.001). In contrast,
the correlation between US-EFW and BW percentiles was highly positive
only in group 1, and significantly lower than that of MRI-EFW/BW
percentiles among the three groups (p<0.001). At the upper
extreme of BW percentiles, MRI had a higher sensitivity with higher
threshold of EFW percentile at a fixed false positive rate of 5%, in
comparison to US regardless of TDI. Conclusions: The
performance of MRI in the prediction of BW is maximal when the delivery
occurs within two weeks of the examination, declining slowly thereafter,
in contrast to the performance of US which decreases drastically over
time.