Unveiling the drivers of fetal weight estimation: which ultrasound measurements matter most?

Fetal weight estimation via ultrasound is performed by measuring biometric parameters such as the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL), which are then used in various mathematical formulas to calculate the estimated weight. But do all parameters matter equally? To assess their contribution on fetal weight estimation, we analyzed 29 published formulas across 26 diverse global datasets. Results show that AC is consistently the parameter of greatest importance, while head measurements (BPD, HC) often add little value, particularly in the later stages of pregnancy. Additionally, nearly half of the formulas include redundant parameters, and two-thirds exhibit a crossover in parameter importance—some transition from low to high significance, while others decline from high to low—over the course of gestation. These findings highlight opportunities to simplify fetal weight estimation for clinicians, prioritizing AC reliability and trimming unnecessary inputs. Our work bridges mathematics and prenatal care, offering clearer guidelines to improve ultrasound-based predictions and support healthier pregnancy outcomes.

Jul 4, 2025 12:00 AM