Focus
Improve the postnatal estimation of gestational age in order to determine preterm birth rates and small for gestational age rates with the goal of 90% to be ± 2 weeks across the gestational age spectrum to 28 weeks out to 42 weeks. Evaluate across sites and by sex.
Background
Preterm birth (PTB) is defined by WHO as all births before 37 completed weeks of gestation or fewer than 259 days since the first day of a woman's last menstrual period (LMP). The gold standard is measurement of crown-rump length by ultrasound before 14 weeks gestation. We need gestational age measures during pregnancy (for management and surveillance) and after birth (on infant for cause of death, for surveillance and outcomes). The needed precision is ± two weeks (one week ideal) but greatest loss of sensitivity/specificity is between two and three weeks for surveillance and for clinical management impairment.
value
The work in this rally demonstrated that the neurological portion of the physical assessments at birth are not necessary for accurate gestational age estimation. This allows for the reduction of tests that need to be done at birth and allows for increased standardization of those assessments.