Biomedical subjects

B J Huffaker

Publications and source records attributed to B J Huffaker.

5 recordsLinked to original sources

PubMed1999

Accurate prediction of term birth weight from prospectively measurable maternal characteristics.

OBJECTIVE: To determine whether accurate prediction of individual term birth weight is possible based on maternal characteristics routinely measured remote from term in healthy women. STUDY DESIGN: Two hundred sixty-two nonsmoking, nondiabetic, white gravidas with uncomplicated term gestations were studied. A cross-validated, split-sample multiple regression analysis was performed to evaluate the predictive value of seven maternal characteristics and two fetal characteristics to identify an optimal combination for accurately estimating birth weight. Fifty-nine terms were assessed for predictive accuracy. RESULTS: Significant predictors of term birth weight were gestational age, parity, fetal sex, maternal height, maternal weight and third-trimester maternal weight gain rate. Combinations of these prospectively measurable variables explained 33% of the variance in birth weight and predicted birth weight to within +/- 267 g (+/- 7.6% of individual birth weight). Term fetal macrosomia was predicted with 80% sensitivity using a prediction cutoff of 3,550 g. CONCLUSION: Individual term birth weight can be accurately predicted in normal gravidas using routinely measurable maternal characteristics. Birth weight estimates using our equation are both prospectively derivable from the beginning of the third trimester and more accurate than any previously devised algorithms, including those that incorporate fetal ultrasonographic data. Our equation can also identify pregnancies at risk for fetal macrosomia so that the timing and mode of delivery may be prospectively modified to minimize peripartum risks to both fetus and mother.

Adult↗

PubMed1995

Fetal weight gain at term: linear with minimal dependence on maternal obesity.

OBJECTIVE: Our purpose was to determine the shape of the function relating birth weight to gestational age between 37.0 and 42.0 weeks of pregnancy and to determine the effect of maternal obesity on term fetal weight gain in normal pregnancies. STUDY DESIGN: Birth weights in 326 singleton, term gestations were studied in nondiabetic, nonsmoking white women who had well-dated, uncomplicated pregnancies. RESULTS: Birth weight was a linear function of gestational age between 37.0 and 42.0 weeks. Mean (+/- SD) fetal weight gain was 12.7 +/- 1.4 gm per day (95% confidence interval 9.9 to 15.5 gm/day). Fetal weight gain was only 0.6 gm per day greater for obese pregnant women than for those of normal weight for height. Male fetuses gained weight 0.5 gm per day faster than females. CONCLUSION: Fetal weight gain is a linear function of gestational age between 37.0 and 42.0 weeks of pregnancy for normal gestations. The effect of maternal obesity on fetal weight gain at term is small and not clinically significant.

Adult↗

PubMed1995

Labor induction with intravaginal misoprostol versus intracervical prostaglandin E2 gel (Prepidil gel): randomized comparison.

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal prostaglandin E1, misoprostol, with that of intracervical prostaglandin E2 (Prepidil gel) for labor induction. STUDY DESIGN: One hundred three patients with an indication for induction of labor were randomly assigned to induction with prostaglandin E1, 50 micrograms intravaginally, or with Prepidil gel, 0.5 mg intracervically, every 4 hours until active labor. RESULTS: Four patients were excluded, leaving 49 patients who received prostaglandin E1 and 50 who received prostaglandin E2. The time from start of induction to vaginal delivery was significantly shorter in the prostaglandin E1 group (11.4 vs 18.9 hours, p < 0.001), and fewer patients in the prostaglandin E1 group required oxytocin augmentation (23% vs 55%, p < 0.005). No significant differences were noted in mode of delivery or in adverse maternal, fetal, or neonatal effects. CONCLUSION: Intravaginal prostaglandin E1 is a more effective, lower-cost agent for induction of labor than is intracervical prostaglandin E2 gel and is comparable in safety.

Administration, Intravaginal↗

PubMed1993

Racial differences in oral glucose screening test results: establishing race-specific criteria for abnormality in pregnancy.

OBJECTIVE: To determine whether the 1-hour glucose screening test threshold of 140 mg/dL yields similar results in identifying gravidas with gestational diabetes mellitus in different races and, if not, to establish consistent race-specific thresholds. METHODS: Nine hundred twenty-one gravidas undergoing routine third-trimester glucose screening were categorized as white, black, Asian, or Filipino. Mean (+/- standard deviation) glucose screening test values, the proportions with results exceeding 140 mg/dL, and the positive predictive values for gestational diabetes mellitus were calculated by race. Race-specific thresholds were calculated by standardizing the percentile rank cutoff for test results in each group. RESULTS: Mean glucose screening test results differed significantly by race: blacks 116.4 +/- 31.6 mg/dL, whites 123.2 +/- 28.4 mg/dL, Filipinos 127.6 +/- 26.3 mg/dL, and Asians 134.7 +/- 25.0 mg/dL (P < .001). No significant difference was found between Hispanic and non-Hispanic whites (123.2 +/- 28.3 versus 123.5 +/- 28.5 mg/dL). Significant different proportions of gravidas exceeded the 140-mg/dL threshold by race: blacks 17.5%, whites 27.4%, Filipinos 31.3%, and Asians 40.6%. The proportions with results above 140 mg/dL who had abnormal 3-hour glucose tolerance tests also varied markedly by race: blacks 42.9%, whites 17.3%, Filipinos 11.5%, and Asians 11.5%. Adjusted screening test thresholds, calculated for each race to establish consistency of the screening test, were 130 mg/dL for blacks, 140 mg/dL for whites, 145 mg/dL for Filipinos, and 150 mg/dL for Asians. CONCLUSION: Race-specific glucose screening test thresholds should be used to ensure consistency in properly identifying gravidas at risk for gestational diabetes mellitus.

Adult↗

PubMed1990

Correlation between first- and early third-trimester glucose screening test results.

One hundred twenty-four normal gravidas had paired first- and early third-trimester (26-32 weeks) 1-hour oral glucose screening tests performed. First-trimester oral glucose screening test values correlated significantly with third-trimester glucose screening test results for the entire population, for whites and non-whites, and for normal-weight and obese patients. First-trimester oral glucose screening test values at or below 110 mg/dL were seldom associated with third-trimester oral glucose screening test results at or above 135 mg/dL and were not associated with abnormal 3-hour glucose tolerance test (GTT) results. Nine of the gravidas (7.3%) were diagnosed with gestational diabetes mellitus during the third trimester, all of whom had first-trimester glucose screening test results above 110 mg/dL. The difference in incidence of gestational diabetes mellitus between gravidas having first-trimester glucose screening test results at or below 110 mg/dL (0%) and those having values above 110 mg/dL (16.4%) was highly significant (P less than .0001). For patients with first-trimester glucose screening test values at or below 110 mg/dL, third-trimester glucose screening may be unnecessary. In contrast, for gravidas having first-trimester glucose screening test results at or above 135 mg/dL, there is a high positive predictive value for elevated repeat glucose screening test results during the early third trimester. Patients having elevated first-trimester glucose screening values at or above 140 mg/dL are at particularly high risk for elevated glucose screening test results later in pregnancy and should forego repeat 1-hour third-trimester glucose screening in favor of a direct third-trimester 3-hour GTT.

Adult↗