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At each study visit, fetal head circumference (HC), abdominal circumference (AC), and femur length (FL) were measured in triplicate to compute EFW at each of 6 study visits (0\u20135). Variability among replicates was assessed across gestation using boxplots and two\u2010way repeated measures ANOVA. For participants with visit 5 EFW (n\u2009=\u20091101), predictive accuracy of each individual measurement and their averages was compared with birthweight using average percent error and proportion within 10% of birthweight. One\u2010way ANOVA and chi\u2010square tests were applied. Sensitivity analyses included second\u2010to\u2010last visit, subgroups classified as small\u2010 or large\u2010for\u2010gestational age, and a subgroup of participants who delivered within 3\u2009days of visit 5.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across visits, replicate HC, AC, and FL showed minimal variability, with no significant differences among replicates or across gestation. At visit 5, average EFW and standard deviations were similar across individual and averaged measurements. Percent errors ranged from 8.2 to 8.5% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.999), and proportion within 10% of birthweight ranged from 64.4 to 66.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.954). Sensitivity analyses produced similarly null findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a controlled research setting with credentialed sonographers and standardized protocols, averaging replicate fetal biometric measurements did not improve EFW prediction of birthweight. A single high\u2010quality measurement of fetal biometry may be sufficient, although further research is warranted to confirm generalizability to routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70180","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:25:52Z","timestamp":1770013552000},"page":"1433-1441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Need for Multiple Ultrasound Measurements for Accurate Prediction of Birthweight Using Estimated Fetal Weight"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9863-9720","authenticated-orcid":false,"given":"Madeleine E.","family":"St. Ville","sequence":"first","affiliation":[{"name":"Biostatistics and Bioinformatics Branch, Division of Population Health Research, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-8534","authenticated-orcid":false,"given":"Katherine L.","family":"Grantz","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Population Health Research, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Gleason","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Population Health Research, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9946-1362","authenticated-orcid":false,"given":"Zhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics Branch, Division of Population Health Research, Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health  Bethesda Maryland 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