Amniotic fluid volume in normal singleton pregnancies: modeling with quantile regression

Arch Gynecol Obstet. 2014 May;289(5):967-72. doi: 10.1007/s00404-013-3087-2. Epub 2013 Nov 17.


Purpose: To develop uniform and reliable reference ranges for amniotic fluid volume (AFV) across gestation in normal singleton pregnancies using quantile regression (QR).

Methods: An analysis of true AFVs determined by dye-dilution techniques or by direct measurement at cesarean delivery in normal singleton pregnancies. AFV centiles were established by QR, a flexible semi-parametric approach of estimating rates of change across the entire distribution of AFV rather than just in the mean as is observed with standard linear regression.

Results: The study evaluated 379 women with normal singleton pregnancies between 16 and 41 weeks gestation. QR was used to determine the association between AFV and gestational age (GA). A second-order quantile regression model indicated a nonlinear relationship between AFV and gestational age at the upper centile range (≥80th percentile).

Conclusion: This study defines normative centile charts for true AFVs between 16 and 41 weeks gestation in normal singleton pregnancies using QR. This statistical approach more appropriately reflects true AFV across gestation at each centile of interest (e.g. 5th, 50th, 95th, etc.) as compared to standard linear regression.

MeSH terms

  • Adult
  • Amniotic Fluid / diagnostic imaging*
  • Cesarean Section
  • Dye Dilution Technique
  • Female
  • Gestational Age
  • Humans
  • Mississippi
  • Oligohydramnios / diagnostic imaging
  • Pregnancy
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Prospective Studies
  • Reference Values
  • Regression Analysis
  • Ultrasonography, Prenatal / methods*