A COMPARISON OF CAUCASIAN AND SOUTHEAST-ASIAN HMONG UTERINE FUNDAL HEIGHT DURING PREGNANCY

Background. Fundal height measurement is a standard clinical assessmen t tool used in prenatal care. This study compared the fundal heights g rowth curves of two ethnically distinct groups of pregnant women. We w ere motivated by our clinical experience with one group when fundal he ights seemed 'small for date' and by the reluctance of this group to u ndergo further testing. especially ultrasound. Method's. A prospective cohort study compared the fundal heights growth curve of 48 Caucasian and 40 Hmong women from two clinics in central Wisconsin (USA). Resul ts. Southeast Asian Hmong women were found to have a slower rate of fu ndal height growth than Caucasian women (significantly different avera ge slopes of .88 vs. .95, respectively). An expectation of linear grow th appeared more valid for Caucasian than Hmong women. At 40 weeks, re gression based estimates overestimated the Caucasian sample by 1.3 wee ks and the Hmong sample by 2.7 weeks. ANCOVA procedures remained signi ficant while controlling for group differences in height. Fundal heigh t measurements were moderately predictive of birth weight for the Hmon g sample but not the Caucasian sample (multiple r = .39). Conclusions. Considerable differences emerged between fundal height measures for t he Hmong and Caucasian samples. The improved ability to differentiate groups following control of variance due to height as well as the abil ity to predict birth weight from fundal height curve in the Hmong grou p argue for value of normative development using more homogeneous grou ps. Clinicians should consider the applicability of fundal height norm s to their clinical populations and may be able to have more confidenc e in using fundal height as an evaluative tool with more appropriate n orms.