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. 2018 Nov 6;18(1):436.
doi: 10.1186/s12884-018-2047-z.

Foetal weight prediction models at a given gestational age in the absence of ultrasound facilities: application in Indonesia

Dewi Anggraini  1   2 , Mali Abdollahian  3 , Kaye Marion  3
Affiliations

Foetal weight prediction models at a given gestational age in the absence of ultrasound facilities: application in Indonesia

Dewi Anggraini et al. BMC Pregnancy Childbirth. .

Abstract

Background: Birth weight is one of the most important indicators of neonatal survival. A reliable estimate of foetal weight at different stages of pregnancy would facilitate intervention plans for medical practitioners to prevent the risk of low birth weight delivery. This study has developed reliable models to more accurately predict estimated foetal weight at a given gestation age in the absence of ultrasound facilities.

Methods: A primary health care centre was involved in collecting retrospective non-identified Indonesian data. The best subset model selection criteria, coefficient of determination, standard deviation, variance inflation factor, Mallows Cp, and diagnostic tests of residuals were deployed to select the most significant independent variables. Simple and multivariate linear regressions were used to develop the proposed models. The efficacy of models for predicting foetal weight at a given gestational age was assessed using multi-prediction accuracy measures.

Results: Four weight prediction models based on fundal height and its combinations with gestational age (between 32 and 41 weeks) and ultrasonic estimates of foetal head circumference and foetal abdominal circumference have been developed. Multiple comparison criteria show that the proposed models were more accurate than the existing models (mean prediction errors between - 0.2 and 2.4 g and median absolute percentage errors between 4.1 and 4.2%) in predicting foetal weight at a given gestational age (between 35 and 41 weeks).

Conclusions: This research has developed models to more accurately predict estimated foetal weight at a given gestational age in the absence of ultrasound machines and trained ultra-sonographers. The efficacy of the models was assessed using retrospective data. The results show that the proposed models produced less error than the existing clinical and ultrasonic models. This research has resulted in the development of models where ultrasound facilities do not exist, to predict the estimated foetal weight at varying gestational age. This would promote the development of foetal inter growth charts, which are currently unavailable in Indonesian primary health care systems. Consistent monitoring of foetal growth would alleviate the risk of having inter growth abnormalities, such as low birth weight that is the most leading factor of neonatal mortality.

Keywords: Absence of ultrasound facilities; Estimated foetal abdominal circumference; Estimated foetal head circumference; Foetal weight estimation; Fundal height; Gestational age; Indonesia; Prediction accuracy; Primary health care centre; Regression analysis.

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Conflict of interest statement

Authors’ information

DA: PhD candidate in the Mathematical Sciences (Applied Statistics), School of Science (Mathematical and Geospatial Sciences), College of Science, Engineering, and Health, RMIT University, Melbourne, Australia and Junior Lecturer at Study Program of Statistics, Faculty of Mathematics and Natural Sciences, University of Lambung Mangkurat (ULM), South Kalimantan, Indonesia.

MA: Senior Lecturer of Statistical Quality Control and its applications in: manufacturing industry, air pollution control, software quality, univariate and multivariate processes, health industry, and the banking system, School of Science (Mathematical and Geospatial Sciences), College of Science, Engineering, and Health, RMIT University, Melbourne, Australia.

KM: Senior Lecturer of Applied Statistics and Mathematics, Market Research, and Numerical Analysis in aerospace engineering, clinical sciences, geomatic engineering, and oncology and carcinogenesis, College of Science, Engineering, and Health, RMIT University, Melbourne, Australia.

Ethics approval and consent to participate

This study is a part of doctoral degree research and has obtained two ethics clearances:

  1. The Ethical Committees of Medical Research, Medical Faculty, University of Lambung Mangkurat (ULM), Banjarmasin, South Kalimantan (Indonesia), on March 10th, 2016, with registration number: 018/KEPK-FK UNLAM/EC/III/2016. Permission to access unidentified secondary data in the preganancy register available at the selected primary health care was also granted under this ethical consideration.

  2. The Science, Engineering, and Health College Human Ethics Advisory Network (CHEAN) of Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Victoria (Australia), on March 16th, 2016, with registration number: ASEHAPP 19-16/RM No: 19974.

Research permissions were obtained from the Indonesian national, provincial, and local governments.

Consent for publication

The manuscript does not contain any individual person’s data; hence consent for publication is not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Conceptual framework for factors influencing foetal weight estimation between 32 and 41 weeks of pregnancy
Fig. 2
Fig. 2
Flowchart of recruitment of participants through the study
Fig. 3
Fig. 3
MEDAPEs comparison between the proposed and commonly used models ordered by GA
See this image and copyright information in PMC

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