Accurate gestational age (GA) dating is important for estimating the due date of a pregnancy and critical to provide interventions for women in preterm labor and for their infants. Ultrasound-dating in early pregnancy is the most accurate method for determining gestational age and the standard of care for pregnancies in high income settings; however, ultrasonography is not widely available in most low-middle income countries. Improving the quality of gestational age data globally is a priority of the Every Newborn Action Plan of the WHO and UNICEF.
A priority research area of the Global AIM lab is to improve the estimation of gestational age in low-resource settings. We are involved in the following projects:
Health providers frequently estimate the due date of a pregnancy by measuring the size of the external uterus, clinically referred to as the symphysis-fundal height (SFH). The Global AIM lab tested if the dating of the pregnancy could be better predicted by measuring the abdominal circumference and using advanced statistical modeling. This implementation research was supported by the Every Preemie Scale program and recently published in BMJ Open.
The Global AIM lab has been conducting systematic reviews of different methods of determining gestational age before and after birth. Our systematic reviews on the accuracy of (1) newborn assessments, (2) foot length, and (3) symphysis fundal height to estimate gestational age were published in (1) Pediatrics, (2) BMJ Global Health, and (3) PLOS One.
The World Health Organization (WHO) AMANHI multicenter study aims to harmonize several ongoing newborn health research studies in sub-Saharan Africa and South Asia to improve understanding of the epidemiology of maternal and neonatal morbidity and mortality. The Global AIM Lab participates in the Gestational Age Study Group.
The WHO AMANHI group has conducted several studies targeting the improvement of gestational age measurement including:
- The Late Pregnancy Ultrasound Study aimed to evaluate and improve the accuracy of the ultrasound scan in estimating gestational age in late pregnancy.
- Neonatal Assessment Study that aims to develop and validate a programmatically feasible and simple approach to assess gestational age of babies after birth.