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Master Thesis

Application des nouvelles courbes Intergrowth-21 en population générale : étude rétrospective sur 18 mois au CHU Sud Réunion

Abstract : Introduction: Screening for suboptimal fetal growth by ultrasound measurements is one of the most important components of antenatal care. Currently French screening rate’s is low. Children born with intra-uterine growth restriction have a higher risk of neonatal death and mobidity. The choice of the fetal growth standard determines the classification and will have an impact on obstetrical care. There are 3 types of chart used in France, CFEF descriptive chart, customized chart and prescriptive growth standards such as those built in the Intergrowth-21 project. Study design: This study aims to evaluate for the first time, the impact of the switching from national curves, to Intergrowth-21 curves in the general population. The study population consisted of 3 697 singleton pregnancies with fetal biometries measured between 22 and 38 weeks of gestation. Z-scores were calculated for each biometry (head circumference, abdominal circumference and femoral length) according to CFEF and Intergrowth-21. Estimated fetal weight and its Z-score were calculated using Hadlock formula (for CFEF) and IG-21 formula. Then sensitivity and specificity of the SGA fetus screening at birth were evaluated with the French Audipog chart. Results: We observed 21% of head circumference, 9% of abdominal circumference and 7% of femoral length below the 10th centile with Intergrowth-21 and 3.6% of head circumference, 5.7% of abdominal circumference and 18.9% of femoral length according to CFEF chart. Concerning the estimated fetal weight, IG-21 standards classified fewer fetuses as SGA than CFEF reference (13.8% and 16.1% , except for fetuses between [36-38] weeks of gestation. The detection sensitivity of SGA fetuses was better with Intergrowth-21 standard at all birth terms, 57.6% versus 47.8% with a sensitivity peak between 33 and 36 weeks at 92.6%. In contrary specificity was 95.8% with CFEF and 94.3% with IG-21 Conclusion: Our study shows good sensitivity in screening SGA fetuses with Intergrowth-21 standards in the general population.
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Master Thesis
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Alice Thoreau. Application des nouvelles courbes Intergrowth-21 en population générale : étude rétrospective sur 18 mois au CHU Sud Réunion. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02301451⟩



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