Fetal growth pathology score: a novel ultrasound parameter for individualized assessment of third trimester growth abnormalities

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.

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Confined placental mosaicism for trisomy 14 and maternal uniparental disomy in association with elevated second trimester maternal serum human chorionic gonadotrophin and third trimester fetal growth restriction

Prenatal Diagnosis ◽

10.1002/pd.75 ◽

2001 ◽

Vol 21 (5) ◽

pp. 395-398 ◽

Cited By ~ 25

Author(s):

Dena R. Towner ◽

Lisa G. Shaffer ◽

Sam P. Yang ◽

Donna D. Walgenbach

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Uniparental Disomy ◽

Maternal Serum ◽

Chorionic Gonadotrophin ◽

Human Chorionic Gonadotrophin ◽

Second Trimester ◽

Third Trimester ◽

Maternal Uniparental Disomy ◽

Placental Mosaicism

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The Presence of the d3-Growth Hormone Receptor Polymorphism Is Negatively Associated with Fetal Growth but Positively Associated with Postnatal Growth in Healthy Subjects

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-0176 ◽

2007 ◽

Vol 92 (7) ◽

pp. 2758-2763 ◽

Cited By ~ 34

Author(s):

Rikke Beck Jensen ◽

Signe Vielwerth ◽

Torben Larsen ◽

Gorm Greisen ◽

Henrik Leffers ◽

...

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Gestational Age ◽

Growth Velocity ◽

Intrauterine Growth Restriction ◽

Postnatal Growth ◽

Third Trimester ◽

Intrauterine Growth ◽

Prenatal Growth ◽

Ghr Gene

Abstract Context: A common polymorphism in the GH receptor (GHR) gene has been linked to increased growth response in GH-treated patients. No former study has focused on the association to prenatal growth. Objective: The aim of the study was to evaluate the association between the d3-GHR isoforms and spontaneous pre- and postnatal growth. Design: A prospective study was conducted on third-trimester fetal growth velocity (FGV), birth weight, birth length, and postnatal growth. Setting: The study was conducted at Copenhagen University Hospital. Participants: A total of 115 healthy adolescents were divided into those born small for gestational age (SGA) and appropriate for gestational age with or without intrauterine growth restriction. Main Outcome Measures: FGV was measured by serial ultrasonography, birth weight, birth length, and adolescent height. Isoforms of the d3-GHR gene (fl/fl, d3/fl, and d3/d3) were determined. Results: The prevalence of the d3-GHR isoforms was 50% but differed among the groups (P = 0.006), with a high prevalence (88%) in the group born SGA with verified intrauterine growth restriction. The d3-GRH allele were associated with decreased third-trimester FGV (P = 0.05) in SGA subjects. In the entire cohort, carriers of the d3-GHR allele had a significantly increased height (−0.10 vs. 0.34 sd score; P = 0.017) and change in height from birth to adolescence compared with carriers of the full-length GHR allele (0.57 vs. −0.02 sd score; P = 0.005). Conclusions: This study showed an increased spontaneous postnatal growth velocity in the carriers of the d3-GHR allele. Interestingly, we found the opposite effect on prenatal growth in the SGA group, with a decreased FGV in carriers of the d3-GHR allele.

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Sonographic Assessment of Fetal Growth Abnormalities

Radiographics ◽

10.1148/rg.2021200081 ◽

2021 ◽

Vol 41 (1) ◽

pp. 268-288

Author(s):

Michelle P. Debbink ◽

Shannon L. Son ◽

Paula J. Woodward ◽

Anne M. Kennedy

Keyword(s):

Fetal Growth ◽

Sonographic Assessment ◽

Growth Abnormalities

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Fetal Thyroid Hormone Level at Birth Is Associated with Fetal Growth

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-2814 ◽

2011 ◽

Vol 96 (6) ◽

pp. E934-E938 ◽

Cited By ~ 60

Author(s):

Beverley M. Shields ◽

Beatrice A. Knight ◽

Anita Hill ◽

Andrew T. Hattersley ◽

Bijay Vaidya

Keyword(s):

Birth Weight ◽

Thyroid Hormone ◽

Cord Blood ◽

Thyroid Function ◽

Fetal Growth ◽

Late Gestation ◽

Third Trimester ◽

Free T4 ◽

Skeletal Size ◽

Fetal Thyroid

Context: Thyroid function is known to play an important role in fetal neurological development, but its role in regulating fetal growth is not well established. Overt maternal and fetal thyroid disorders are associated with reduced birth weight. We hypothesized that, even in the absence of overt thyroid dysfunction, maternal and fetal thyroid function influence fetal growth. Aim: In normal, healthy pregnancies, we aimed to assess whether fetal thyroid hormone at birth (as measured in cord blood) is associated with fetal growth. We also aimed to study whether fetal thyroid hormone at birth is associated with maternal thyroid hormone in the third trimester. Methods: In 616 healthy mother-child pairs, TSH, free T4 (FT4), and free T3 (FT3) were measured in mothers at 28 wk gestation and in umbilical cord blood at birth. Birth weight, length, head circumference, and tricep and bicep skinfold thicknesses were measured on the babies. Results: Cord FT4 was associated with birth weight (r = 0.25; P < 0.001), length (r = 0.17; P < 0.001), and sum of skinfolds (r = 0.19; P < 0.001). There were no associations between birth measurements and either cord TSH or cord FT3. Maternal FT4 and cord FT4 were correlated (r = 0.14; P = 0.0004), and there were weaker negative associations between maternal TSH and cord FT4 (r = −0.08; P = 0.04) and FT3 (r = −0.10; P = 0.01). Conclusion: Associations between cord FT4 and birth size suggest that fetal thyroid function may be important in regulating fetal growth, both of skeletal size and fat. The correlation between third-trimester maternal FT4 and cord FT4 supports the belief that maternal T4 crosses the placenta even in late gestation.

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Sonographic Assessment of Fetal Growth Abnormalities

RadioGraphics ◽

10.1148/rg.2020200081.pres ◽

2020 ◽

Author(s):

Michelle P. Debbink ◽

Shannon L. Son ◽

Paula J. Woodward ◽

Anne M. Kennedy

Keyword(s):

Fetal Growth ◽

Sonographic Assessment ◽

Growth Abnormalities

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Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity

Journal of Clinical Medicine ◽

10.3390/jcm9113504 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3504

Author(s):

Małgorzata Lewandowska ◽

Barbara Więckowska ◽

Lidia Sztorc ◽

Stefan Sajdak

Keyword(s):

Smoking Cessation ◽

Birth Weight ◽

Cigarette Smoking ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Odds Ratio ◽

Maternal Obesity ◽

First Trimester ◽

Third Trimester ◽

The Mean

Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.

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