Fetal weight estimation by ultrasound: development of Indian population-based models

Purpose: Existing ultrasound-based fetal weight estimation models have been shown to have high errors when used in the Indian population. Therefore, the primary objective of this study was to develop Indian population-based models for fetal weight estimation, and the secondary objective was to compare their performance against established models. Methods: Retrospectively collected data from 173 cases were used in this study. The inclusion criteria were a live singleton pregnancy and an interval from the ultrasound scan to delivery of >= 7 days. Multiple stepwise regression (MSR) and lasso regression methods were used to derive fetal weight estimation models using a randomly selected training group (n=137) with cross-products of abdominal circumference (AC), biparietal diameter (BPD), head circumference (HC), and femur length (FL) as independent variables. In the validation group (n=36), the bootstrap method was used to compare the performance of the new models against 12 existing models. Results: The equations for the best-fit models obtained using the MSR and lasso methods were as follows: log(10)(EFW)=2.7843700+0.0004197(HCxAC)+0.0008545(ACxFL) and log(10)(EFW)=2.38 70211110+0.0074323216(HC)+0.0186555940(AC)+0.0013463735(BPD x FL)+0.0004519715 (HCxFL), respectively. In the training group, both models had very low systematic errors of 0.01% (+/- 7.74%) and -0.03% (+/- 7.70%), respectively. In the validation group, the performance of these models was found to be significantly better than that of the existing models. Conclusion: The models presented in this study were found to be superior to existing models of ultrasound-based fetal weight estimation in the Indian population. We recommend a thorough evaluation of these models in independent studies.