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The Validity of Gestational Age Estimation by Menstrual Dating in Term, Preterm, and Postterm Gestations
Abstract
Despite recognition that estimation of gestational age (GA) based on maternal recollection of the last normal menstrual period (LNMP) is fraught with error, it is not generally appreciated that the magnitude and direction of this error vary as a function of the LNMP estimate. Early second-trimester (16 to 18 weeks) ultrasound determinations of the fetal biparietal diameter were used as the "gold standard" to test the validity of LNMP-based GA estimates in 11,045 women. The large majority of deliveries occurring at or near term showed LNMP estimates that were valid within plus or minus seven days of the ultrasound estimate. As the LNMP GA deviated progressively toward earlier or later GAs, however, the discrepancies became quite marked, especially for postterm dates. The positive predictive values of the LNMP GA estimates decreased dramatically from term (.949) to preterm (.775) to postterm (.119) deliveries. These systematic errors in menstrual GA estimates have profound implications for unnecessary induction, dysfunctional labor and cesarean section, and resultant neonatal and maternal morbidity.
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Citations
Cited by
Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A.-B., Narwal, R., Adler, A., Vera Garcia, C., Rohde, S., Say, L., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60820-4 · Cited by 4,568
A New and Improved Population-Based Canadian Reference for Birth Weight for Gestational Age
Kramer, M. S., Platt, R. W., Wen, S. W., Joseph, K. S., Allen, A., Abrahamowicz, M., Blondel, B., Bréart, G., & for the Fetal/Infant Health Study Group of the Canadian Perinatal Surveillance System (2001) · Pediatrics · doi:10.1542/peds.108.2.e35 · Cited by 1,524
Self-citationIntensive Care for Extreme Prematurity — Moving beyond Gestational Age
Tyson, J. E., Parikh, N. A., Langer, J., Green, C., & Higgins, R. D. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa073059 · Cited by 986
Preterm Birth and Psychiatric Disorders in Young Adult Life
Nosarti, C., Reichenberg, A., Murray, R. M., Cnattingius, S., Lambe, M. P., Yin, L., MacCabe, J., Rifkin, L., & Hultman, C. M. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.1374 · Cited by 477
Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination
Savitz, D. A., Terry, J. W., Dole, N., Thorp, J. M., Siega-Riz, A. M., & Herring, A. H. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.127601 · Cited by 437
Metadata
- Authors
- Kramer, M. S.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1988-12-09
- Volume
- 260
- Issue
- 22
- Pages
- 3306
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1985791683
- Cited by
- 435
- References
- 0
- FWCI
- 11.23
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: The Validity of Gestational Age Estimation by Menstrual Dating in Term, Preterm, and Postterm Gestations. https://app.cochat.ai/papers/10.1001/jama.1988.03410220090034
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- Kramer, M. S. (1988). The Validity of Gestational Age Estimation by Menstrual Dating in Term, Preterm, and Postterm Gestations. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.1988.03410220090034
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