{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T19:04:59Z","timestamp":1732043099038,"version":"3.28.0"},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objectives\u2003This study aimed to evaluate which of four established norms should be used for sonographic assessment of fetal femur length (FL).<\/jats:p><jats:p>\n            Study Design\u2003Cross-sectional study using pooled data from four maternal\u2013fetal medicine practices. Inclusion criteria were singleton fetus, gestational age (GA) 220\/7 to 396\/7 weeks, biometry measured, and fetal cardiac activity present. Four norms of FL were studied: Hadlock et al, the INTERGROWTH-21st Project (IG-21st), the World Health Organization Fetal Growth Curves (WHO), and the National Institutes of Child Health and Human Development Fetal Growth Studies, unified standard (NICHD-U). The fit of our FL measurements to each norm was assessed by these criteria: mean z-score close to 0, standard deviation (SD) of z close to 1, Kolmogorov\u2013Smirnov D-statistic close to zero, Youden J-statistic close to 1, approximately 5% of exams &lt;5th percentile, and approximately 5% of exams &gt;95th percentile.<\/jats:p><jats:p>\n            Results\u2003In 26,177 ultrasound exams, our FL measurements had the best fit to the WHO standard (mean z-score 0.15, SD of z 1.02, D-statistic &lt;0.01, J-statistic 0.95, 3.4% of exams &lt;5th percentile, 7.0% of exams &gt;95th percentile). The mean of the IG-21st standard was smaller than the other norms and smaller than our measurements, resulting in underdiagnosis of short FL. The mean of the Hadlock reference was larger than the other norms and larger than our measurements, resulting in overdiagnosis of short FL. The SD of the NICHD-U standard was larger than the other norms and larger than our observations, resulting in underdiagnosis of both short and long FL. Restricting the analysis to a subgroup of 7,144 low-risk patients without risk factors for large- or small-for- GA produced similar results.<\/jats:p><jats:p>\n            Conclusion\u2003Of the norms studied, the WHO standard is likely best for diagnosis of abnormal FL.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2196-6835","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T23:14:02Z","timestamp":1698102842000},"page":"e3147-e3156","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Selection of Standards for Sonographic Fetal Femur Length by Use of z-Scores"],"prefix":"10.1055","volume":"41","author":[{"given":"C Andrew","family":"Combs","sequence":"additional","affiliation":[{"name":"Pediatrix Center for Research, Education, Quality & Safety, Pediatrix Medical Group, Sunrise, Florida"},{"name":"Obstetrix of San Jose, Campbell, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Del Rosario","sequence":"additional","affiliation":[{"name":"Obstetrix of San Jose, Campbell, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaide","family":"Ashimi Balogun","sequence":"additional","affiliation":[{"name":"Obstetrix Maternal-Fetal Medicine Specialists, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary S.","family":"Bowman","sequence":"additional","affiliation":[{"name":"Perinatal Associates of Sacramento, Sacramento, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushma","family":"Amara","sequence":"additional","affiliation":[{"name":"Eastside Maternal-Fetal Medicine Specialists, Bellevue, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"issue":"11","key":"ref1","first-page":"E13","article-title":"AIUM-ACR-ACOG-SMFM-SRU practice parameter for the performance of standard diagnostic obstetric ultrasound examinations","volume":"37","year":"2018","journal-title":"J Ultrasound Med"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/uog.20272","article-title":"ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth","volume":"53","author":"L J Salomon","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00404-021-06394-z","article-title":"The femur too short? 1373 fetuses with short femur during second-trimester screening","volume":"306","author":"U Friebe-Hoffmann","year":"2022","journal-title":"Arch Gynecol Obstet"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/uog.5349","article-title":"Association of isolated short femur in the mid-trimester fetus with perinatal outcome","volume":"31","author":"B Weisz","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"268218","DOI":"10.5402\/2012\/268218","article-title":"Outcome of fetuses with diagnosis of isolated short femur in the second half of pregnancy","volume":"2012","author":"J Morales-Rosell\u00f3","year":"2012","journal-title":"ISRN Obstet Gynecol"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1002\/uog.5265","article-title":"Outcome of fetuses with antenatally diagnosed short femur","volume":"31","author":"A T Papageorghiou","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/uog.6359","article-title":"Prenatal sonographic diagnosis of skeletal dysplasias","volume":"34","author":"T Schramm","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/uog.12364","article-title":"Meta-analysis of second-trimester markers for trisomy 21","volume":"41","author":"M Agathokleous","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ajog.2022.09.045","article-title":"Should we offer prenatal exome sequencing for intrauterine growth restriction or short long bones? 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Part I","volume":"141","author":"G D O'Brien","year":"1981","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1055\/s-2007-999989","article-title":"A longitudinal study of fetal limb growth","volume":"1","author":"P Jeanty","year":"1984","journal-title":"Am J Perinatol"},{"issue":"01","key":"ref17","first-page":"69","article-title":"Fetal femur length: a critical reevaluation of the relationship to menstrual age","volume":"66","author":"A H Warda","year":"1985","journal-title":"Obstet Gynecol"},{"key":"ref18","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-70423-9","volume-title":"Ultrasound Diagnosis in Obstetrics and Gynecology","author":"M Hansmann","year":"1986"},{"issue":"11","key":"ref19","first-page":"873","article-title":"Curve trasversali dell'accrescimento fetale. Studio multicentrico","volume":"38","author":"U Nicolini","year":"1986","journal-title":"Minerva Ginecol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/j.1471-0528.1994.tb13078.x","article-title":"Charts of fetal size: 4. Femur length","volume":"101","author":"L S Chitty","year":"1994","journal-title":"Br J Obstet Gynaecol"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1046\/j.1469-0705.1994.04010034.x","article-title":"Fetal biometry at 14-40 weeks' gestation","volume":"4","author":"R J Snijders","year":"1994","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref22","first-page":"877","article-title":"Standard values of ultrasonographic fetal biometry","volume":"23","author":"N Shinozuka","year":"1996","journal-title":"Jpn J Med Ultrasonics"},{"volume-title":"Ultraljud: Obstetrik Och Gynekologi","year":"1998","author":"B M Weldner","key":"ref23"},{"issue":"06","key":"ref24","first-page":"628","article-title":"Reference charts of foetal biometry in Asians","volume":"36","author":"F M Lai","year":"1995","journal-title":"Singapore Med J"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1055\/s-2007-1003172","article-title":"Das normale fetale Wachstumsprofil\u2013ein einheitliches Modell zur Berechnung von Normkurven f\u00fcr die g\u00e4ngigen Kopf- und Abdomen-parameter sowie die grossen Extremit\u00e4tenknochen","volume":"17","author":"E Merz","year":"1996","journal-title":"Ultraschall Med"},{"issue":"09","key":"ref26","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/(SICI)1097-0096(199811\/12)26:9<433::AID-JCU3>3.0.CO;2-O","article-title":"Ultrasound fetal biometry charts for a North American Caucasian population","volume":"26","author":"V A Lessoway","year":"1998","journal-title":"J Clin Ultrasound"},{"volume-title":"Biom\u00e9trie foetale: standards de croissance et croissance individuelle","year":"1999","author":"A M Guihard-Costa","key":"ref27"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1471-0528.1999.tb08213.x","article-title":"Fetal ultrasound biometry: 2. Abdomen and femur length reference values","volume":"106","author":"J Kurmanavicius","year":"1999","journal-title":"Br J Obstet Gynaecol"},{"issue":"06","key":"ref29","first-page":"435","article-title":"Biom\u00e9trie 2000. Tables de croissance foetale par le Coll\u00e8ge fran\u00e7ais d'\u00e9chographie foetale (CFEF) et l'Inserm U 155","volume":"28","author":"J Cr\u00e9quat","year":"2000","journal-title":"Gyn\u00e9col Obst\u00e9t Fertil"},{"issue":"03","key":"ref30","first-page":"299","article-title":"Charts of Thai fetal biometries: 3. Femur length","volume":"83","author":"V Titapant","year":"2000","journal-title":"J Med Assoc Thai"},{"key":"ref31","first-page":"3","article-title":"Ultrasound fetal measurement standardization and Japanese standard","volume":"30","author":"Japan Society of Ultrasound in Medicine","year":"2003","journal-title":"J Med Ultrason"},{"issue":"08","key":"ref32","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/j.0001-6349.2005.00691.x","article-title":"Fetal age assessment based on femur length at 10-25 weeks of gestation, and reference ranges for femur length to head circumference ratios","volume":"84","author":"S L Johnsen","year":"2005","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1440-1673.2004.01384.x","article-title":"Ultrasonic fetal size measurements in Brisbane, Australia","volume":"48","author":"P J Schluter","year":"2004","journal-title":"Australas Radiol"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1002\/pd.1158","article-title":"Fetal size charts for the Italian population. 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N Leung","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1002\/uog.5225","article-title":"New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study","volume":"31","author":"B O Verburg","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"23","DOI":"10.7863\/jum.2013.32.1.23","article-title":"Establishment of fetal biometric charts using quantile regression analysis","volume":"32","author":"E Daniel-Spiegel","year":"2013","journal-title":"J Ultrasound Med"},{"issue":"04","key":"ref40","doi-asserted-by":"crossref","first-page":"449.e1","DOI":"10.1016\/j.ajog.2015.08.032","article-title":"Racial\/ethnic standards for fetal growth: the NICHD Fetal Growth Studies","volume":"213","author":"G M Buck Louis","year":"2015","journal-title":"Am J 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Perinatol"},{"issue":"04","key":"ref47","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/uog.6439","article-title":"Use of Z-scores to select a fetal biometric reference curve","volume":"34","author":"N Sananes","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"01","key":"ref48","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1186\/s12884-020-03183-5","article-title":"Fetal biometry assessment with Intergrowth 21st's and Salomon's equations in rural Burkina Faso","volume":"20","author":"B Bihoun","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"10","key":"ref49","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/S2213-8587(14)70121-4","article-title":"The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study","volume":"2","author":"J Villar","year":"2014","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2196-6835.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:47:48Z","timestamp":1730814468000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2196-6835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,23]]},"references-count":49,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2196-6835","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2023,10,23]]},"published":{"date-parts":[[2023,10,23]]}}}