Multicenter Study

. 2025 Feb 26;25(1):214.

doi: 10.1186/s12884-025-07295-8.

Gestational age reference from crown-rump length during 11-14 weeks: a population-based multicenter cohort study in China

Yixiu Zhang^#¹, Zihan Niu^#¹, Hua Meng², Yuxin Jiang^#³, Zhonghui Xu¹, Yunshu Ouyang¹, Shengli Li⁴, Qian Chen⁵, Qingqing Wu⁶, Rui Li⁷, Tong Ru⁸, Ailu Cai⁹, Xinlin Chen¹⁰, Taizhu Yang¹¹, Ping Chen¹², Hongning Xie¹³, Hong Lu¹⁴, Qing Dai¹, Fen Dong¹⁵, Meng Yang¹, Xiao Yang¹, Jia Lu¹, Jiawei Tian¹⁶, Kun Sun¹⁷, Hui Li¹⁸

Affiliations

¹ Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
² Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China. menghua_pumch@163.com.
³ Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China. jiangyuxinxh@163.com.
⁴ Department of Ultrasound, Shenzhen Maternity and Child Healthcare Hospital Affiliated to Nanfang Medical University, Shenzhen, P.R. China.
⁵ Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, P.R. China.
⁶ Department of Ultrasonography, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, P.R. China.
⁷ Department of Ultrasonography, Southwest Hospital of the Third Medical University, Chongqing, P.R. China.
⁸ Department of Ultrasound, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, P.R. China.
⁹ Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, P.R. China.
¹⁰ Department of Ultrasound, Hubei Maternal and Child Health Hospital, Wuhan, P.R. China.
¹¹ Department of Ultrasonography, West China Second Hospital of Sichuan University, Chengdu, P.R. China.
¹² Department of Ultrasonography, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
¹³ Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
¹⁴ Department of Ultrasound, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China.
¹⁵ Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, P.R. China.
¹⁶ Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
¹⁷ Department of Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
¹⁸ Department of Obstetrics, Shengjing Hospital of China Medical University, Shenyang, P.R. China.

^# Contributed equally.

PMID: 40011832
PMCID: PMC11866846
DOI: 10.1186/s12884-025-07295-8

Multicenter Study

Gestational age reference from crown-rump length during 11-14 weeks: a population-based multicenter cohort study in China

Yixiu Zhang et al. BMC Pregnancy Childbirth. 2025.

. 2025 Feb 26;25(1):214.

doi: 10.1186/s12884-025-07295-8.

Authors

Affiliations

¹ Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
² Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China. menghua_pumch@163.com.
³ Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China. jiangyuxinxh@163.com.
⁴ Department of Ultrasound, Shenzhen Maternity and Child Healthcare Hospital Affiliated to Nanfang Medical University, Shenzhen, P.R. China.
⁵ Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, P.R. China.
⁶ Department of Ultrasonography, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, P.R. China.
⁷ Department of Ultrasonography, Southwest Hospital of the Third Medical University, Chongqing, P.R. China.
⁸ Department of Ultrasound, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, P.R. China.
⁹ Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, P.R. China.
¹⁰ Department of Ultrasound, Hubei Maternal and Child Health Hospital, Wuhan, P.R. China.
¹¹ Department of Ultrasonography, West China Second Hospital of Sichuan University, Chengdu, P.R. China.
¹² Department of Ultrasonography, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
¹³ Department of Ultrasonic Medicine, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
¹⁴ Department of Ultrasound, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China.
¹⁵ Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, P.R. China.
¹⁶ Department of Ultrasound, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.
¹⁷ Department of Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
¹⁸ Department of Obstetrics, Shengjing Hospital of China Medical University, Shenyang, P.R. China.

^# Contributed equally.

PMID: 40011832
PMCID: PMC11866846
DOI: 10.1186/s12884-025-07295-8

Abstract

Background: This study aimed to develop a new ultrasonographic dating formula to estimate gestational age (GA) based on fetal crown-rump length (CRL) in a Chinese population, evaluate model accuracy and compare its performance with established dating formulas.

Methods: A prospective, multicenter study was conducted across mainland China. Participants included healthy, low-risk women with spontaneously conceived singleton pregnancies and a regular menstrual cycle in the preceding year. Ultrasonography was performed between 11 and 14 weeks of gestation, with GA determined based on the last menstrual period. Participants were randomly assigned to a development or validation cohort in a 7:3 ratio. A best-fit regression model was constructed for GA estimation based on CRL in the development cohort. For validation, mean differences between the new estimated GA and menstrual age were calculated and compared with those obtained using five established CRL-based dating formulas in the validation cohort. All participants were followed through to delivery.

Results: The study recruited 4,710 women with singleton pregnancies, with 3,297 in the development cohort and 1,413 women in the validation cohort. The mean and standard deviation values of CRL changed linearly with GA during 11-14 weeks. CRL demonstrated a linear relationship with GA between 11 and 14 weeks, yielding the regression equation GA = 59.590085 + 0.458539×CRL (R² = 0.8042). The mean difference between estimated GA and menstrual age was 0.32 days (95% confidence interval 0.17-0.46), demonstrating a smaller error compared with those obtained from the five widely used CRL dating formulas.

Conclusions: We derived a CRL-based dating formula applicable to naturally conceived pregnancies at 11-14 weeks. This new formula exhibits small residuals, providing a more accurate alternative to existing CRL-based dating formulas.

Keywords: Crown–rump length; Gestational age; Ultrasound.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Peking Union Medical College Hospital and other relevant hospitals. All pregnant women participating in this study signed informed consent forms. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
Scatter plot between gestational age (GA) and gestational age (GA) in the training group

See this image and copyright information in PMC

References

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Gestational age reference from crown-rump length during 11-14 weeks: a population-based multicenter cohort study in China

Affiliations

Gestational age reference from crown-rump length during 11-14 weeks: a population-based multicenter cohort study in China

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources