205: Application of different fetal head circumference normality ranges for the identification of abnormal head growth in Zika infected fetuses in a Colombian Cohort

2017 ◽  
Vol 216 (1) ◽  
pp. S131
Author(s):  
Magdalena Sanz-Cortes ◽  
Mayel Yepez ◽  
Ana Maria Rivera ◽  
Alexander J. Zarutskie ◽  
Joan Mastrobatista ◽  
...  
2020 ◽  
Author(s):  
Ohad Regev ◽  
Gal Cohen ◽  
Amnon Hadar ◽  
Jeny Schoster ◽  
Hagit Flusser ◽  
...  

Background: Despite evidence for the prenatal onset of abnormal head growth in ASD children, studies on fetal ultrasound data in ASD are limited and controversial. Methods: A longitudinal matched case-sibling-control study on prenatal ultrasound biometric measures of ASD children was conducted. Children with ASD were matched to two control groups: (1) typically developed sibling (TDS) and (2) typically developed population (TDP). The cohort comprised 528 children (72.7% males): 174 ASD, 178 TDS, and 176 TDP. Results: Second-trimester ASD and TDS fetuses had significantly smaller biparietal diameter (BPD) than TDP fetuses (aORzBPD=0.685, 95%CI=0.527−0.890 and aORzBPD=0.587, 95%CI=0.459−0.751, respectively). However, these differences became statistically indistinguishable in the third trimester. Head biometric measures were associated with the sex of the fetus, with males having larger heads than females within and across groups. A linear mixed-effect model assessing the effects of sex and group assignment on fetal longitudinal head growth indicated faster BPD growth in TDS vs both ASD and TDP in males (β=0.084 and β=0.100 respectively; p<0.001) but not in females, suggesting an ASD−sex interaction in head growth during gestation. Fetal head shape showed sex-specific characteristics, and head growth was inversely correlated with ASD severity in males and females, thus further supporting the sex effect on the association between fetal head growth and ASD. Conclusions: Our findings suggest that abnormal fetal head growth is a familial trait of ASD, which is modulated by sex and is associated with the severity of the disorder. Thus, it could serve as an early biomarker for ASD.


2017 ◽  
Author(s):  
Jamille Gregório Dombrowski ◽  
Rodrigo Medeiros de Souza ◽  
Flávia Afonso Lima ◽  
Carla Letícia Bandeira ◽  
Oscar Murillo ◽  
...  

ABSTRACTBackgroundMalaria in pregnancy is associated with adverse effects on the fetus and newborns. However, the outcome on a newborn’s head circumference (HC) is still unclear. Here, we show the relation of malaria during pregnancy with fetal head growth.MethodsClinical and anthropometric data were collected from babies in two cohort studies of malaria-infected and non-infected pregnant women, in the Brazilian Amazon. One enrolled prospectively (PCS, Jan. 2013 to April 2015) through volunteer sampling, and followed until delivery, 600 malaria-infected and non-infected pregnant women. The other assembled retrospectively (RCS, Jan. 2012 to Dec. 2013) clinical and malaria data from 4697 pregnant women selected through population-based sampling. The effects of malaria during pregnancy in the newborns were assessed using a multivariate logistic regression. According with World Health Organization guidelines babies were classified in small head (HC < 1 SD below the median) and microcephaly (HC < 2 SD below the median) using international HC standards.ResultsAnalysis of 251 (PCS) and 232 (RCS) malaria-infected, and 158 (PCS) and 3650 (RCS) non-infected women with clinical data and anthropometric measures of their babies was performed. Among the newborns, 70 (17.1%) in the PCS and 934 (24.1%) in the RCS presented with a small head (SH). Of these, 15 (3.7%) and 161 (4.2%), respectively, showed microcephaly (MC). The prevalence of newborns with a SH (30.7% in PCS and 36.6% in RCS) and MC (8.1% in PCS and 7.3% in RCS) was higher among babies born from women infected withPlasmodium falciparumduring pregnancy. Multivariate logistic regression analyses revealed thatP. falciparuminfection during pregnancy represents a significant increased odds for the occurrence of a SH in newborns (PCS: OR 3.15, 95% CI 1.52-6.53, p=0.002; RCS: OR 1.91, 95% CI 1.21-3.04, p=0.006). Similarly, there is an increased odds of MC in babies born from mothers that wereP. falciparum-infected(PCS: OR 5.09, 95% CI 1.12-23.17, p=0.035). Moreover, characterization of placental pathology corroborates the association analysis, particularly through the occurrence of more syncytial nuclear aggregates and inflammatory infiltrates in placentas from babies with the reduced head circumference.ConclusionsThis work indicates that falciparum-malaria during pregnancy presents an increased likelihood of occurring reduction of head circumference in newborns, which is associated with placental malaria.Trial Registrationregistered as RBR-3yrqfq in the Brazilian Clinical Trials Registry


Author(s):  
Marion Lecorguillé ◽  
Juliane Léger ◽  
Anne Forhan ◽  
Marie Cheminat ◽  
Marie-Noëlle Dufourg ◽  
...  

Abstract Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalana M. Sol ◽  
Charissa van Zwol - Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
Maria-Pilar Martinez-Moral ◽  
...  

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.


2021 ◽  
pp. 088307382199610
Author(s):  
Amanda Leong ◽  
Amalia Floer ◽  
Adam Kirton ◽  
Aleksandra Mineyko

Background: Perinatal stroke is a leading cause of hemiparetic cerebral palsy and lifelong disability. Neurodevelopmental outcomes are difficult to predict and markers of long-term poor outcome continue to be investigated. Deceleration in growth of head circumference has been associated with worse developmental outcomes in neonatal brain injury. We hypothesized that perinatal stroke would result in decreased rates of head growth during childhood that would be associated with worse developmental outcomes. Methods: Patients with magnetic resonance imaging (MRI)–confirmed neonatal arterial ischemic stroke and arterial presumed perinatal ischemic stroke were identified from a population-based research cohort (Alberta Perinatal Stroke Project). Demographics and occipital-frontal circumference data were collected from medical records. Head growth was compared to typically developing control charts using a 2-tailed t test. The Fisher exact test was used to examine associations between Pediatric Stroke Outcome Measures (PSOM) scores and occipital-frontal head circumference. Results: Three hundred fifteen occipital-frontal head circumference measurements were collected from 102 patients (48 female, 54 male), over a median of 3.2 years (standard deviation = 5.18, range = 0-18.3). After 3 months for female patients and 1 year for male patients, occipital-frontal head circumference deviated and remained below normal growth trajectories ( P < .05) with a large effect size (Cohen d >0.8). Poor outcome (PSOM ≥ 1) was associated with smaller occipital-frontal head circumference ( P < .05). Conclusion: Head growth deceleration is observed in children with perinatal arterial ischemic stroke and is associated with poor outcome. Head circumference may be a tool to alert clinicians to the potential of abnormal neurologic outcome.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Thomas A Miller ◽  
Victor Zak ◽  
Peter Shrader ◽  
Chitra Ravishankar ◽  
Victoria L Pemberton ◽  
...  

Poor somatic growth is common in infants with single ventricle (SV) physiology and has been linked to increased morbidity and impaired neurodevelopment. Asymmetry in somatic growth, a potential brain-sparing adaptation, is important in predicting outcomes in premature and small for gestational age (SGA) infants. Objectives: To assess variability in growth asymmetry and its associations with neurodevelopment in infants with SV. Methods: We analyzed growth asymmetry (weight for age z-score (WAZ) minus head circumference for age z-score (HCAZ)), relative head growth (change in cm/change in kg), HCAZ, and change in HCAZ from baseline to pre-Glenn in subjects prospectively enrolled in the Pediatric Heart Network Infant Single Ventricle (ISV) trial. Associations between these indices and results of the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development-II (BSID) at 14 months were assessed. Results: Of the 230 patients enrolled in ISV, complete biometric data and BSID results were available in 168 (73%). For this cohort, age at enrollment was 21±9 days, age at pre-Glenn was 167±52 days, gestational age was 38.3±1.4 weeks, and 71% were male. Growth asymmetry varied across the cohort at enrollment (0.43 ±1.02, range -2.85 to 4.84) and the pre-Glenn visit (-0.23 ±1.21, range -4.45 to 3.00) as did the relative head growth (2.40±0.86, range 0.50 to 8.00). BSID scores were not associated with indices of growth asymmetry. In univariate analysis, larger pre-Glenn HCAZ correlated with higher MDI (r=0.21, p=0.006) and PDI (r=0.38, p<0.001) and greater increase in HCAZ from enrollment to pre-Glenn was associated with higher PDI (r=0.15, p=0.049). In multivariable modeling adjusting for site, serious adverse events, stage 1 length of stay, and height at 14 months, pre-Glenn HCAZ was an independent predictor of PDI (p=0.03), but not MDI. For each one unit Z-score increase in pre-Glenn HCAZ, the predicted PDI score increased by 2.5 points. Conclusions: In infants with SV, BSID scores were associated with pre-Glenn HCAZ but not with the degree of asymmetric growth. Future studies should explore why asymmetric growth that seems important in premature and SGA infants appears less relevant in infants with SV.


2018 ◽  
Vol 41 (05) ◽  
pp. 544-549 ◽  
Author(s):  
Ladina Vonzun ◽  
Franziska Maria Winder ◽  
Martin Meuli ◽  
Ueli Moerlen ◽  
Luca Mazzone ◽  
...  

Abstract Purpose The aim of this study was to describe the sonographic evolution of fetal head circumference (HC) and width of the posterior horn of the lateral ventricle (Vp) after open fetal myelomeningocele (fMMC) repair and to assess whether pre- or postoperative measurements are helpful to predict the need for shunting during the first year of life. Patients & Methods All 30 children older than one year by January 2017 who previously had fMMC repair at the Zurich Center for Fetal Diagnosis and Therapy were included. Sonographic evolution of fetal HC and Vp before and after fMMC repair was assessed and compared between the non-shunted (N = 16) and the shunted group (N = 14). ROC curves were generated for the fetal HC Z-score and Vp in order to show their predictive accuracy for the need for shunting until 1 year of age. Results HC was not an independent factor for predicting shunting. However, the need for shunting was directly dependent on the preoperative Vp as well as the Vp before delivery. A Vp > 10 mm at evaluation for fMMC repair or > 15 mm before delivery identifies 100 % of the infants needing shunt placement at a false-positive rate of 44 % and 25 %, respectively. All fetuses with a Vp > 15 mm at first evaluation received a shunt. Conclusion Fetuses demonstrating a Vp of > 15 mm before in utero MMC repair are extremely likely to develop hydrocephalus requiring a shunt during the first year of life. This compelling piece of evidence must be appropriately integrated into prenatal counseling.


2018 ◽  
Vol 218 (3) ◽  
pp. 339.e1-339.e7 ◽  
Author(s):  
Michal Lipschuetz ◽  
Sarah M. Cohen ◽  
Ariel Israel ◽  
Joel Baron ◽  
Shay Porat ◽  
...  

2005 ◽  
Vol 58 (11-12) ◽  
pp. 548-552 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.


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