Evaluation of the accuracy of a prognostic model for the risk of fetal macrosomia

Tysyachny O.V., Romanov A.Yu., Baev O.R., Grebenshchikova L.Yu.

1) Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 3) Tver State Medical University, Ministry of Health of Russia, Tver, Russia

The Fetal Medicine Foundation (FMF) has demonstrated that the risk of having a large baby and/or fetal macrosomia can be predicted based on screening data in the first trimester. Numerous models for predicting fetal macrosomia have been described in contemporary scientific literature. However, due to the limited effectiveness, these predictive models are not used in clinical practice. Given that fetal macrosomia is associated with a high risk of adverse obstetric and neonatal outcomes, it is important to estimate the value of the prediction model for the birth of a large fetus created by the FMF.
Objective: To explore the discriminatory ability and prognostic value of the FMF prediction model for large for gestational age fetus. 
Materials and methods: We conducted a retrospective validation cohort study. It included 600 participants who were divided into two groups. The main group (n=300) consisted of women who gave birth to large for gestational age babies (baby’s weight equal to or over the 90th percentile). The comparison group (n=300) included women who gave birth to babies weighing between the 10th and the 90th percentiles. Large for gestational age was defined when birth weight was equal to the 90th percentile for their gestational age.  
Results: We identified the differences in the values of weight, height and the PAPP-A levels (MoM) in the examined women (p<0.0001 and p=0.02), that were higher in group I (fetal macrosomia). ROC analysis showed a moderate ability of the model to distinguish between the patients with a high and low risk of developing macrosomia:  AUC of 0.66, sensitivity – 59.68%, specificity – 56.82%, positive predictive value – 49.33%, negative predictive value – 66.67%, and accuracy – 58%.
Conclusion: Our study explored the discriminatory ability of the FMF model and its predictive value for having large for gestational age babies in the population of the Russian women. Analysis of the calibration curve showed that the model is characterized by satisfactory preservation of relative risks, but requires baseline risk adjustment. We believe that the differences in prediction accuracy are due to application of this model in different populations.

Authors' contributions: Tysyachny O.V. –  study concept and design, data collection and analysis; Romanov A.Yu.  – statistical analysis; Baev O.R. – manuscript editing; Grebenshchikova L.Yu – manuscript writing. 
Conflicts of interest: The authors declare that they have no conflicts of interest.
Funding: The study was carried out without any sponsorship.
Ethical Approval: The study was approved by the local Ethics Committee of V.I. Kulakov National Medical Research Center 
for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: The patients have signed informed consent for participation in the study and publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Tysyachny O.V., Romanov A.Yu., Baev O.R., Grebenshchikova L.Yu. 
Evaluation of the accuracy of a prognostic model for the risk of fetal macrosomia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 68-74 (in Russian)
https://dx.doi.org/10.18565/aig.2025.309

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About the Authors

Oleg V. Tysyachny, PhD, Researcher at the 1st Maternity Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4, o_tysyachny@oparina4.ru, https://orcid.org/ 0000-0001-9282-9817
Andrey Yu. Romanov, PhD, Head of the Department of Planning and Support of Scientific Projects, V.I. Kulakov National Medical Research Center for Obstetrics,
Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4, romanov1553@yandex.ru
Oleg R. Baev, Dr. Med. Sci., Professor, Head of the 1st Maternity Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology,
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, o_baev@oparina4.ru, https://orcid.org/0000-0001-8572-1971
Lyudmila Yu. Grebenshchikova, PhD, Head of the Department of Reproductive Medicine and Perinatology, Tver State Medical University, Ministry of Health of Russia;
General Director, Medical Center «Consilium», 170039, Russia, Tver, Pozharnaya sqr., 3, +7(4822)368550, ludmilazdrav@mail.ru, klinika.concilium@mail.ru,
https://orcid.org/0000-0003-2815-1882

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