Results
A total of 127 women were treated for PPROM in our institution during
the study time period. Of these, 106 women met inclusion criteria and
were included in analysis (Table 1). All of our patients completed at
least one course of betamethasone prior to delivery. Among these, 48
(45%) screened positive with the FMF fetal growth chart and 22 (21%)
screened positive for SGA by the Hadlock method (RR 7.6 95%CI: 2.4
-24.3; p < .001). SGA was diagnosed in 12 infants (11%). Both
fetal growth charts were statistically significant predictors of SGA,
Hadlock: AUC = .76, RR 7.6 95%CI: 2.5- 23; p < .001, FMF:
AUC: .76 RR 1.8-13.3 95% CI: 1.8 – 99.3; p = < .001. The
diagnostic accuracy for SGA of the Hadlock fetal growth chart was
similar to the FMF fetal growth chart (Figure 3). The sensitivity,
specificity, positive and negative predictive values are presented in
Table 2. Four SGA neonates were missed with the Hadlock fetal growth
chart, and only one SGA was missed with the FMF fetal growth chart.
For our secondary outcomes, FGR by the Hadlock and FMF fetal growth
chart had similar poor prediction ability for the composite of severe
neonatal outcomes (Hadlock: AUC: .51, RR: .84 95%CI: .5-1.6 vs. FMF:
ROC: .56 RR: 1.6 95%CI: .7-3.5; p = .23) (Figure 3). SNO complicated
only two of the 12 SGA infants (17%) vs. 40 (42%) of the infants with
appropriate weight for gestational age (AGA); RR .4 95% CI: .1-1.4; p =
.012. Both of the SGA infants with SNO had RDS and one was also
diagnosed with NEC.
SGA would have been diagnosed in 39% of our participant when both the
fetal and neonatal FMF growth charts vs. 11% utilizing the Alexander
birthweight growth chart (RR= 3.3 95% CI: 2.3-4: p = < .001).
The FMF fetal chart was a statistically significant predictor of SGA
defined by the FMF neonatal standard (AUC: .74, RR: 3.5 95% CI: 2- 6.2;
p = < .001), but the FMF neonatal standard was not accurate
predictor for the composite of neonatal outcomes (AUC: .56 RR:1.3
95%CI: .8-2.1; p = .23). The sensitivity, specificity, positive, and
negative predictive value accuracy of the FMF standards are presented in
Table 2.