{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:04:51Z","timestamp":1776319491597,"version":"3.50.1"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health"},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800013C"],"award-info":[{"award-number":["HHSN275200800013C"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800002I"],"award-info":[{"award-number":["HHSN275200800002I"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN27500006"],"award-info":[{"award-number":["HHSN27500006"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800003IC"],"award-info":[{"award-number":["HHSN275200800003IC"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800014C"],"award-info":[{"award-number":["HHSN275200800014C"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800012C"],"award-info":[{"award-number":["HHSN275200800012C"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275200800028C"],"award-info":[{"award-number":["HHSN275200800028C"]}]},{"name":"Federal Funds for the NICHD Fetal Growth Studies including ARRA funding","award":["HHSN275201000009C"],"award-info":[{"award-number":["HHSN275201000009C"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to examine associations of fetal biometric and amniotic fluid measures with intrapartum primary cesarean delivery (PCD) and develop prediction models for PCD based on ultrasound parameters and maternal factors.<\/jats:p><jats:p>\n            Study Design\u2003Secondary analysis of the National Institute of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies\u2014singleton cohort (2009\u20132013) including patients with uncomplicated pregnancies and intent to deliver vaginally at \u2265370\/7 weeks. The estimated fetal weight, individual biometric parameters, fetal asymmetry measurements, and amniotic fluid single deepest vertical pocket assessed at the final scan (mean 37.5\u2009\u00b1\u20091.9 weeks) were categorized as &lt;10th, 10th to 90th (reference), and &gt;90th percentiles. Logistic regression analyses examined the association between the ultrasound measures and PCD. Fetal and maternal SuperLearner prediction algorithms were constructed for the full and nulliparous cohorts.<\/jats:p><jats:p>\n            Results\u2003Of the 1,668 patients analyzed, 249 (14.9%) had PCD. The fetal head circumference, occipital\u2013frontal diameter, and transverse abdominal diameter &gt;90th percentile (adjusted odds ratio [aOR]\u2009=\u20092.50, 95% confidence interval [95% CI]: 1.39, 4.51; aOR\u2009=\u20091.86, 95% CI: 1.02, 3.40; and aOR\u2009=\u20092.13, 95% CI: 1.16, 3.89, respectively) were associated with PCD. The fetal model demonstrated poor ability to predict PCD in the full cohort and in nulliparous patients (area under the receiver-operating characteristic curve [AUC]\u2009=\u20090.56, 95% CI: 0.52, 0.61; and AUC\u2009=\u20090.54, 95% CI: 0.49, 0.60, respectively). Conversely, the maternal model had better predictive capability overall (AUC\u2009=\u20090.79, 95% CI: 0.75, 0.82) and in the nulliparous subgroup (AUC\u2009=\u20090.72, 95% CI: 0.67, 0.77). Models combining maternal\/fetal factors performed similarly to the maternal model (AUC\u2009=\u20090.78, 95% CI: 0.75, 0.82 in full cohort, and AUC\u2009=\u20090.71, 95% CI: 0.66, 0.76 in nulliparas).<\/jats:p><jats:p>\n            Conclusion\u2003Although a few fetal biometric parameters were associated with PCD, the fetal prediction model had low performance. In contrast, the maternal model had a fair-to-good ability to predict PCD.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1788274","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T23:43:30Z","timestamp":1722296610000},"page":"256-267","source":"Crossref","is-referenced-by-count":1,"title":["Fetal and Maternal Factors Predictive of Primary Cesarean Delivery at Term in a Low-Risk Population: NICHD Fetal Growth Studies\u2014Singletons"],"prefix":"10.1055","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct00912132","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6886-4807","authenticated-orcid":false,"given":"Julio","family":"Mateus","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Atrium Health, Charlotte, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle R.","family":"Stevens","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine L.","family":"Grantz","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuilin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Global Center for Asian Women's Health and the Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagteshwar","family":"Grewal","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Owen","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony C.","family":"Sciscione","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Christiana Hospital, Newark, Delaware"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald J.","family":"Wapner","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Skupski","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, New York Presbyterian Queens, Flushing, New York and Weill Cornell Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Chien","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cleveland Clinic Health System, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah A.","family":"Wing","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, and Long Beach Memorial Medical Center\/Miller Children's Hospital Irvine, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela C.","family":"Ranzini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology. The MetroHealth System, Cleveland, Ohio; Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Nageotte","sequence":"additional","affiliation":[{"name":"Maternal-Fetal medicine Specialist, Miller Children's and Women's Hospital, Long Beach, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger B.","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"36.e1","DOI":"10.1016\/j.ajog.2008.03.007","article-title":"Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery","volume":"199","author":"S L 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