Population Standards of Birth Weight Underestimate Fetal Growth Abnormalities in Diabetic Pregnancies

Abstract Improvements in modern sow prolificacy have markedly increased the number of pigs weaned, thus the ability of sows to provide nutrients to support fetal growth and milk production has been enhanced. The goals of the gestation nutrition program consist of meeting the nutrient requirements for maintenance and growth and for adequate conceptus development, while managing body condition. Early gestation represents the best opportunity for replenishing body reserves, whereas in late gestation, both estimated protein deposition and energy requirement are exponentially increased and directed towards fetal growth and mammary development. Increased feed intake after breeding has been presumed to be detrimental to embryo survival; however, data with modern line sows demonstrates to feed thin sows to recover body condition as quickly as possible while avoiding feed deprivation immediately after breeding. Importance of body condition scoring remains unchanged: feed thin sows to bring back to adequate body condition and prevent over-conditioned sows at farrowing. A recent meta-analysis showed increasing late gestation feed intake seems to modestly improve piglet birth weight by 28 g per piglet in gilts and sows. Also, recent findings in gestating sows suggest modern genotypes have improved feed efficiency and propensity for growth. Therefore, increasing energy intake during late gestation has a modest effect on piglet birth weight and a negative effect on stillborn rate. Historically, lactation catabolism impacted subsequent reproductive performance of sows, particularly in first-parity. However, contemporary sows appear to be increasingly resistant to the negative effects of lactational catabolism. Even so, continued emphasis on maximizing lactation feed intake is critical to support milk production and prevent excessive lean tissue mobilization. Research data suggests that ad libitum feeding and offering lactation diets during the wean-to-estrus interval is not needed. Modern genetic sow lines appear to be more robust from a nutritional perspective than in the past.

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Comparison of fetal growth estimates based on birth weight and ultrasound references

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/jmf.12.4.247.252 ◽

2002 ◽

Vol 12 (4) ◽

pp. 247-252 ◽

Cited By ~ 13

Author(s):

A. G. Fry ◽

I. M. Bernstein ◽

G. J. Badger

Keyword(s):

Birth Weight ◽

Fetal Growth

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OC40: A comparison of 2D and 3D ultrasound methods of assessing fetal fat in growth abnormalities using customised birth weight outcomes

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.4146 ◽

2007 ◽

Vol 30 (4) ◽

pp. 379-379

Author(s):

G. K. Parry

Keyword(s):

Birth Weight ◽

3D Ultrasound ◽

Weight Outcomes ◽

2D And 3D ◽

Growth Abnormalities

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The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0371 ◽

2018 ◽

Vol 46 (2) ◽

pp. 163-168 ◽

Cited By ~ 3

Author(s):

Ana Raquel Neves ◽

Filipa Nunes ◽

Miguel Branco ◽

Maria do Céu Almeida ◽

Isabel Santos Silva

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Predictive Value ◽

Fetal Growth Restriction ◽

Predictive Performance ◽

Growth Restriction ◽

Operating Characteristics ◽

Tertiary Center ◽

Fetal Malformations ◽

Twin Pregnancies

AbstractObjective:To analyze the accuracy of ultrasound prediction of birth weight discordance (BWD) and the influence of chorionicity and fetal growth restriction (FGR) on ultrasound performance.Methods:Retrospective analysis of 176 twin pregnancies at a Portuguese tertiary center, between 2008 and 2014. Last ultrasound biometry was recorded. Cases with delivery before 24 weeks, fetal malformations, interval between last ultrasound and deliver >3 weeks, twin-to-twin transfusion syndrome and monoamniotic pregnancies were excluded. The accuracy of prediction of BWD was assessed using the area under the receiver-operating characteristics curve (AUC).Results:BWD ≥20% was present in 21.6% of twin pregnancies. EBW had the best predictive performance for BWD (AUC 0.838, 95%CI 0.760–0.916), with a negative predictive value of 86.9% and a positive predictive value of 51.3%. Chorionicity did not influence ultrasound performance. None of the biometric variables analyzed was predictive of BWD in pregnancies without FGR.Conclusion:The accuracy of ultrasound in the prediction of BWD is limited, particularly in pregnancies without fetal growth restriction. Clinical decisions should not rely on BWD alone.

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DIAGNOSIS OF IMPAIRED FETAL GROWTH IN NEWBORN INFANTS

PEDIATRICS ◽

10.1542/peds.48.4.511 ◽

1971 ◽

Vol 48 (4) ◽

pp. 511-522 ◽

Cited By ~ 1

Author(s):

Herbert C. Miller ◽

Khatab Hassanein

Keyword(s):

Birth Weight ◽

Soft Tissue ◽

Body Length ◽

Fetal Growth ◽

Head Circumference ◽

Soft Tissue Mass ◽

Newborn Infants ◽

Tissue Mass ◽

Growth Impairment ◽

Short Body

Measurements of crown-heel length, head circumference, and birth weight were made on a large number of newborn infants. Birth weight by itself was frequently not a valid measure of fetal growth impairment. By including measurements of body length and head size along with birth weight, four distinct patterns of fetal growth impairment were identified. The four patterns included infants who had abnormally short body lengths for dates, infants who had evidence of disproportionate growth between body length and head circumference, infants who accumulated excessive amounts of soft-tissue mass, and infants who accumulated too little soft-tissue mass. Criteria for diagnosing each pattern were obtained prospectively and have been presented with allowances made for the effects of race, sex, fetal age, and parity on each pattern. The separate identification of the four patterns provided a more precise description of fetal growth impairment than could be obtained from birth weight and calculated gestational age.

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Tracking of Body Composition Variables

PEDIATRICS ◽

10.1542/peds.80.5.779 ◽

1987 ◽

Vol 80 (5) ◽

pp. 779-783

Author(s):

David W. Harsha ◽

Carey G. Smoak ◽

Theresa A. Nicklas ◽

Larry S. Webber ◽

Gerald S. Berenson

Keyword(s):

Body Composition ◽

Birth Weight ◽

Early Detection ◽

Significant Degree ◽

Anthropometric Variable ◽

Skinfold Measurements ◽

Growth Abnormalities

Height, weight, and skinfold measurements were obtained on a cohort of 447 children from birth (weight) or 6 months of age (height and skinfold) and monitored yearly thereafter until 7 years of age. At age 7 years, 250 remained for follow-up screening. A significant degree of tracking was found for all variables from age 1 to age 7 years. Height and weight tracked most strongly (age 1- to 7-year correlations = .42 and .44, respectively), whereas skinfold tracked somewhat lower (.28). Earlier levels of each anthropometric variable were the best predictor of later levels of that parameter. Implications for early detection and treatment of growth abnormalities are discussed.

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Fetal Growth Retardation: Femurs, Fontanels, and Follow-up

PEDIATRICS ◽

10.1542/peds.62.4.446 ◽

1978 ◽

Vol 62 (4) ◽

pp. 446-453

Author(s):

Alistair G.S. Philip

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Growth Retardation ◽

Head Circumference ◽

Ponderal Index ◽

Length Ratio ◽

Fetal Growth Retardation ◽

Anterior Fontanel ◽

Group 3

Sixty-three term newborn infants with fetal growth retardation were evaluated within three days of birth. They were classified by length and head circumference. In group 1, both length and head circumference were less than the tenth percentile; in group 2, either length or head circumference was less than the tenth percentile; and in group 3, both length and head circumference were greater than the tenth percentile. Ponderal index (weight/length ratio), anterior fontanel size, and amount of epiphyseal ossification were also determined. Significantly lower birth weights and decreased ossification were found when groups 1 or 2 were compared separately with group 3. These differences were most marked when the weight/length ratio was less than 2.25. When the ponderal index was less than 2.0, epiphyseal ossification was usually absent (suggesting a chronic process). Epiphyseal ossification was positively correlated with birth weight and length but was unrelated to anterior fontanel size. Ossification was more often absent in males than in females. There was a negative (inverse) correlation between birth weight and anterior fontanel size. Follow-up of 32 of these infants at age 1 year showed marked individual variations, but there were significant differences in incremental linear growth between groups 1 and 3, a finding which supports results of animal studies showing that catch-up growth may be related to skeletal immaturity. Physical measurements at birth in the individual baby with fetal growth retardation do not reliably predict subsequent growth.

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