The use of clinical, biochemical, and ultrasound parameters for the diagnosis of intrauterine growth retardation.

Fifty-four pregnant patients referred for nonstress testing with findings suggestive of intrauterine growth retardation (IUGR) were followed with serial biochemical determinations and ultrasound evaluations. Confirmation of IUGR was made in 18 of the neonates based on body weights below the 10th percentile. Stepwise discriminate function analysis was used to determine the factors most predictive of IUGR among several clinical, biochemical, and ultrasound parameters as well as their combinations. Only the determinations closest to the time of delivery were used in analysis. The presence of abnormal fetal ultrasound measurements had the highest predictive value. Prepregnancy weight improved the prediction slightly with a proportion of correct predictions increasing from 70 to 74%. Only the extremes of prepregnancy weight altered the prediction made on the basis of ultrasound. In contrast, no significant predictive value was demonstrated for weight gain, heavy cigarette smoking, hypertension, serum estriol, human placental lactogen, alpha-fetoprotein, or a decrease in amniotic fluid volume, either singly or in combination with other variables.