{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:50:23Z","timestamp":1772801423861,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,5,24]],"date-time":"2011-05-24T00:00:00Z","timestamp":1306195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the accuracy of 21 sonographic fetal weight\u2010estimation models and abdominal circumference (AC) as a single measure for the prediction of fetal macrosomia (&gt; 4000 g) using either fixed or optimal model\u2010specific thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 4765 sonographic weight estimations performed within 3 days prior to delivery were analyzed. The predictive accuracy of 21 published sonographic fetal weight\u2010estimation models was calculated using three different thresholds: a fixed threshold of 4000 g; a model\u2010specific threshold obtained from the inflexion point of the receiver\u2013operating characteristics (ROC) curve; and a model\u2010specific threshold associated with the highest overall accuracy. Cluster analysis was used to determine whether a certain combination of fetal biometric indices is associated with a higher predictive accuracy than others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For a fixed threshold of &gt; 4000 g, there was considerable variation among the models in sensitivity (range, 13.6\u201398.5%) and specificity (range, 63.6\u201399.8%) for fetal macrosomia. Use of the threshold derived from the inflexion point of the ROC curve decreased the intermodel variation to a minimum (sensitivity, 84.4\u201391.4%; and specificity, 79.5\u201386.3%). Even when this optimal model\u2010specific threshold was applied, models based on three to four biometric indices were more accurate than were models based on only two biometric indices or on AC as a single measure (<jats:italic>P<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sonographic fetal weight\u2010estimation models based on three to four biometric indices appear to be more accurate than are models based on two indices or on AC as a single measure, for the diagnosis of macrosomia. In these cases, the use of an optimal, model\u2010specific threshold is associated with a higher degree of accuracy than is the uniform use of a fixed threshold of an estimated weight of &gt; 4000 g. Copyright \u00a9 2011 ISUOG. 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