A new simple method to estimate the gestational age from chest x-ray measurements in newborns and preterm infants

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2017

Poster Number:

C-2712

Type:

Scientific Exhibit

Keywords:

Paediatric, Thorax, Lung, Conventional radiography, Diagnostic procedure, eLearning, Statistics, Congenital, Education and training, Epidemiology

Authors:

J. A. Prat-Matifoll, J. Piqueras, A. Prats-Uribe, C. Parra-Fariñas, E. Maciag, C. D. Hernández Giraldo, C. A. Ortiz Andrade, J. C. Carreño; Barcelona/ES

DOI:

10.1594/ecr2017/C-2712

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-2712

Fig. 1: Three simple measures were obtained from chest A-P exams. Dorsal spine length...

Fig. 3: ROC curve for a Dorsal Spine Length of 90 mm to differentiate preterm newborns...

Fig. 4: ROC curve for a triple combination of the 3 measurements (dorsal spine length,...

Fig. 2: R squared correlation was calculated for each measure with the same measure in...

Aims and objectives

1. Introduction:Why is it important to know the gestational age in a newborn? The importance of differentiating between pre-term and term newborns [1] Preterm birth complications are estimated to be responsible for 35% of the world’s annual neonatal deaths. Furthermore, these complicationsare the second most common cause of death after pneumonia in children under 5 years old. Preterm birth increases the risk of death due to neonatal infections and in almost all countries, preterm birth is the leading cause of child deaths as well as...

Methods and materials

-Patient characteristics This study includes 274 newborns full-term, critically ill and premature, admitted to a neonatal intensive care unit (NICU) between september 2014 and september 2015, both included. This scientific exhibit divides newborns into 3 main groups: pre-term (70.75%), term (28.89%) and post-term (0.36%). The pre-term group was subdivided in extremely preterm (16.97%), very preterm (19.85%) and moderate/late preterm (33.93%). This classification is based on the WHO guidelines which define preterm birth as any birth before 37 completed weeks of gestation, or fewer than 259...

Results

Multiple threshold measures were obtained in order to establish an optimal value (high sensitivity and specificity)to classify newborns into pre-term (extremely preterm, very preterm and moderate/late preterm), term and post-term. Threshold valuesobtained by measurements taken in A-P chest x-ray exams: 1.One key measure to differentiate preterm from term and postterm newborns (Fig.3): - Dorsal Spine length: 90mm S: 90.82% (IC 86- 94.5%) PPV: 92.2% E: 81.48% (IC 71.3-89.2%) NPV: 78.6% 2.Three key measures to differentiate between extremely and very preterm from late preterm and term...

Conclusion

Dorsal Spine Length (DSL) and Right Pulmonary Length (RPL), and their combinations, are quick and reliable estimates of the gestational age of full-term and preterm newborns. These measures and their combinations allow radiologists to classify newborns into pre-term (extremely preterm, very preterm and moderate/late preterm), term and post-term just by measurements taken on A-P chest plain films.

Personal information

J.A Prat-Matifoll Vall Hebron University Hospital - Barcelona Mail: [email protected]

References

1. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. The Lancet. 2012;379(9832):2162-2172. doi: 10.1016/S0140-6736(12)60820-4. 2. Butt K, Lim K, Bly S, et al. Determination of Gestational Age by Ultrasound. Journal of Obstetrics and Gynaecology Canada. 2014;36(2):171-181. doi: 10.1016/S1701-2163(15)30664-2. 3. Harkness UF, Mari G. Diagnosis and management of intrauterine growth restriction. Clin Perinatol 2004;31(4):743-764 doi:10.1016/j.clp.2004.06.006 4. Scioscia M, Vimercati A,...