Lithium exposure during pregnancy increases fetal growth

Background: Lithium is an effective treatment in pregnancy and postpartum for the prevention of relapse in bipolar disorder, but there is a lack of knowledge about the potential adverse impact on fetal development. Aims: To investigate the impact of lithium exposure on early fetal growth. Methods: In this retrospective observational cohort study, we included all singleton pregnancies of women using lithium and referred for advanced fetal ultrasound scanning between 1994 and 2018 to the University Medical Centers in Leiden and Rotterdam, the Netherlands ( n=119). The Generation R study, a population-based cohort, served as a non-exposed control population from the same geographic region ( n=8184). Fetal head circumference, abdominal circumference, femur length, and transcerebellar diameter were measured by ultrasound at 18–22 weeks of gestation. Results: Lithium use during pregnancy was associated with an average increase in head circumference of 1.77 mm (95% confidence interval: 0.53, 3.01), in abdominal circumference of 5.54 mm (95% confidence interval: 3.95, 7.12) and in femur length of 0.59 mm (95% confidence interval: 0.22, 0.96) at 18–22 weeks gestation. Furthermore, lithium use during pregnancy was associated with an average increase in birth weight of 142.43 grams (95% confidence interval: 58.01, 226.89), whereas it was associated with an average decrease of 1.41 weeks in gestational duration (95% confidence interval: −1.78, −1.05). Conclusions: Lithium use during pregnancy was associated with increased fetal growth parameters at 18–22 weeks gestational age and increased birth weight. Further research is needed to evaluate both short- and long-term implications, as well as the mechanisms driving this difference in growth.

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Accuracy of ultrasonic fetal weight estimation using head and abdominal circumference and femur length

Medicinski pregled ◽

10.2298/mpns0512548m ◽

2005 ◽

Vol 58 (11-12) ◽

pp. 548-552 ◽

Cited By ~ 1

Author(s):

Ljiljana Mladenovic-Segedi ◽

Dimitrije Segedi

Keyword(s):

Birth Weight ◽

Head Circumference ◽

Fetal Weight ◽

Abdominal Circumference ◽

Weight Estimation ◽

Fetal Head ◽

Total Body Mass ◽

Femur Length ◽

Fetal Weight Estimation ◽

Gynecology And Obstetrics

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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The Impact of Gender on Anthropometric Measures of Twins

Twin Research and Human Genetics ◽

10.1017/thg.2016.57 ◽

2016 ◽

Vol 19 (6) ◽

pp. 652-658 ◽

Cited By ~ 1

Author(s):

Shayesteh Jahanfar ◽

Kenneth Lim

Keyword(s):

Birth Weight ◽

Birth Order ◽

Fetal Growth ◽

Gestational Age ◽

Head Circumference ◽

Population Based ◽

Birth Length ◽

Anthropometric Measures ◽

Fetal Birth Weight ◽

The Impact

Introduction: Literature suggests that male hormones influence fetal growth in singleton pregnancies. We hypothesized that the same phenomenon is seen in twin gestations. Objectives: (1) to identify the impact of gender associated with fetal birth weight, head circumference, and birth length for twins; (2) to examine the effect of gender on standardized fetal growth at birth, according to gestational age and birth order; (3) to examine the effect of gender on placenta weight and dimensions. Methodology: This was a population-based retrospective cohort study of twins (4,368 twins, 2,184 pairs) born in British Columbia, Canada from 2000–2010. We excluded twins with stillbirth, congenital anomalies, and those delivered with cesarean section. We also controlled for confounding factors, including birth order, gestational age, maternal anthropometric measures, maternal smoking habits, and obstetric history. A subsample of this population was analyzed from Children and Women Hospital to obtain chorionicity information. Results: Male–male twins were heavier than male–females and female–female twin pairs (p=.01). Within sex-discordant twin pairs, males were also heavier than females (p=.01). Regression analysis suggested that gender affects birth weight independent of birth order and gestational age. Other newborn anthropometric measures were not found to be dependent on gender. In analyzing a subsample with chorionicity data, birth weight was the only anthropometric measure that was both statistically and clinically affected by sex, even after adjustment for gestational age, chorionicity, birth order, and maternal age. Conclusion: Birth weight was affected by gender while head circumference and birth length were not.

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Association of Maternal Vegetarian Diets with Neonatal Anthropometry in the NICHD Fetal Growth Study (OR35-08-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.or35-08-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Samrawit Yisahak ◽

Stefanie Hinkle ◽

Sunni Mumford ◽

Mengying Li ◽

Victoria Andriessen ◽

...

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Proportional Hazards ◽

First Trimester ◽

Cox Proportional Hazards ◽

Birth Length ◽

Abdominal Circumference ◽

Vegetarian Diets ◽

The Impact ◽

Time To Delivery

Abstract Objectives Vegetarian diets appear to reduce risk of chronic disease in the general population, but the possible effect on fetal growth is understudied. Our aim was to examine associations of gestational vegetarianism (self-defined and operationalized) with neonatal anthropometry. Methods We studied 1964 women who had a singleton livebirth in a diverse multi-site cohort of U.S. pregnant women (2009-2013). To assess peri-conception and first trimester diet, women completed a 145-item self-administered Food Frequency Questionnaire at enrollment (8-13 weeks’ gestation). Self-defined vegetarians said “yes” to the question “For all of the past 3 months, did you follow a vegetarian diet?”. Operationalized vegetarianism was defined based on servings of first trimester meat, poultry, and fish (MPF) intake (vegetarian = MPF < 1 month; pesco-vegetarian = MP < 1 month and fish ≥ 1 month; semi-vegetarian = MPF ≥ 1 month and < 1 week). Birthweight was abstracted from medical records and neonatal anthropometrics (upper-arm length, upper-thigh length, head circumference, abdominal circumference, skinfold thickness) were measured post-delivery using a standard protocol. Linear regression was used to model neonatal outcomes. To assess the association of vegetarianism with gestational age, we also used cox proportional hazards models to estimate time to delivery. Results There were 99 (6.03%) self-defined, 32 (1.91%) operationalized, 7 (0.42%) pesco- and 321 (19.12%) semi-vegetarians. Neonates of vegetarians had significantly lower birth weight and birth length than nonvegetarians in adjusted models (Figure). Associations with all other measures of neonatal anthropometrics were null. Time to delivery HR (95% CI) was 1.08 (0.88, 1.34), 0.94 (0.65, 1.24), 0.68 (0.32, 1.45), and 0.96 (0.84, 1.10) for self-defined, operationalized, pesco- and semi-vegetarians respectively. Conclusions Both self-defined and operationalized vegetarianism was significantly associated with decreased birth weight and birth length. Further work is needed to better understand the impact of this maternal diet on the neonate. Funding Sources Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Supporting Tables, Images and/or Graphs

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The Impact of Neonatal Morbidities on Child Growth and Developmental Outcome in Very Low Birth Weight Infants: Nationwide Cohort Study

10.21203/rs.3.rs-168031/v1 ◽

2021 ◽

Author(s):

Jung Ho Han ◽

So Jin Yoon ◽

Joo Hee Lim ◽

Jeong Eun Shin ◽

Ho Seon Eun ◽

...

Keyword(s):

Birth Weight ◽

Preterm Infants ◽

Head Circumference ◽

Growth Parameters ◽

Periventricular Leukomalacia ◽

Normal Growth ◽

Child Growth ◽

Growth Restriction ◽

Neurodevelopmental Outcomes ◽

The Impact

Abstract IntroductionGrowth in preterm infants has long-term implications for neurodevelopmental outcomes. We aimed to estimate the nationwide growth outcomes from birth to 5 years in infants born under 1,500 g and to analyze the effects of major morbidities of preterm infants on growth.MethodsTotal 2,961 children with birth weight under 1,500 g who were born in 2013 and examined the Infant Health Check-up between 2013 and 2018 from the National Health Insurance Service database were included. Check-ups were at 4-6, 9-12, 18-24, 30-36, 42-48, and 54-60 months of age. Information was obtained by the International Classification of Diseases-10 codes or by the questionnaire in the check-up program.ResultsAt 60 months of age, mean percentiles of weight, height, and head circumference showed only 30 – 40th percentile of normal growth for their ages. About 30% had growth parameters below the 10th percentile and showed worse neurodevelopmental outcomes. Using multiple logistic regression, infants with bronchopulmonary dysplasia showed significantly higher incidence of growth restriction in all three categories, weight (odds ratio [OR] 1.50), height (OR 1.33), and head circumference (OR 1.36) at 60 months. Sepsis was associated with growth restriction in weight (OR 1.43) and head circumference (OR 1.33). Periventricular leukomalacia infants had relatively small head circumferences (OR 1.91) and poor developmental screening results (OR 2.89).ConclusionCatch-up growth remains a major issue in infants born under 1,500 g, especially those with some morbidities of preterm birth. Regular check-ups to monitor and early intervention for their normal growth is essential.

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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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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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Prenatal maternal stress and birth outcomes in rural Ghana: sex-specific associations

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2535-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Kenneth Ayuurebobi Ae-Ngibise ◽

Blair J. Wylie ◽

Ellen Boamah-Kaali ◽

Darby W. Jack ◽

Felix Boakye Oppong ◽

...

Keyword(s):

Birth Weight ◽

Birth Outcomes ◽

Fetal Growth ◽

Head Circumference ◽

Maternal Stress ◽

Birth Outcome ◽

Sub Saharan Africa ◽

Adverse Birth Outcome ◽

Prenatal Maternal Stress ◽

Rural Ghana

Abstract Background In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana. Methods Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined. Results In all children, high prenatal maternal stress was associated with reduced birth length (β = − 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = − 0.16, p = 0.02; β = − 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = − 0.66, p = 0.05; β = − 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys. Conclusions All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies. Trial registration NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.

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Gestational Diabetes Mellitus: Predictive Value of Fetal Growth Measurements by Ultrasonography at 22–24 Weeks: A Retrospective Cohort Study of Medical Records

Nutrients ◽

10.3390/nu12123645 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3645

Author(s):

Danyao Jin ◽

Janet Wilson Rich-Edwards ◽

Chunyi Chen ◽

Yue Huang ◽

Yinping Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fetal Growth ◽

Medical Records ◽

Generalized Estimating Equations ◽

Abdominal Circumference ◽

Fetal Head ◽

Femur Length ◽

Fetal Size

Early intervention of gestational diabetes mellitus (GDM) is effective in reducing pregnancy disorders. Fetal growth, measured by routine ultrasound scan a few weeks earlier before GDM diagnosis, might be useful to identify women at high risk of GDM. In the study, generalized estimating equations were applied to examine the associations between ultrasonic indicators of abnormal fetal growth at 22–24 weeks and the risk of subsequent GDM diagnosis. Of 44,179 deliveries, 8324 (18.8%) were diagnosed with GDM between 24 and 28 weeks. At 22–24 weeks, fetal head circumference (HC) < 10th, fetal femur length (FL) < 10th, and estimated fetal weight (EFW) < 10th percentile were associated with 13% to 17% increased risks of maternal GDM diagnosis. Small fetal size appeared to be especially predictive of GDM among women who were parous. Fetal growth in the highest decile of abdominal circumference (AC), HC, FL and EFW was not associated with risk of subsequent GDM. The observed mean difference in fetal size across gestation by GDM was small; there was less than 1 mm difference for AC, HC, and FL, and less than 5 g for EFW before 24 weeks. Despite similar mean fetal growth among women who were and were not later diagnosed with GDM, mothers with fetuses in the lowest decile of HC, FL and EFW at 22–24 weeks tended to have higher risk of GDM.

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Correlation models for monitoring fetal growth

Statistical Methods in Medical Research ◽

10.1177/0962280220905623 ◽

2020 ◽

Vol 29 (10) ◽

pp. 2795-2813 ◽

Cited By ~ 1

Author(s):

Yuan Feng ◽

Luo Xiao ◽

Cai Li ◽

Stephanie T Chen ◽

Eric O Ohuma

Keyword(s):

Fetal Growth ◽

Abdominal Circumference ◽

Fetal Head ◽

Femur Length ◽

Second Stage ◽

Correlation Models ◽

Biparietal Diameter ◽

Z Scores ◽

Using Data ◽

Shiny Application

Ultrasound growth measurements are monitored to evaluate if a fetus is growing normally compared with a defined standard chart at a specified gestational age. Using data from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st project, we have modelled the longitudinal dependence of fetal head circumference, biparietal diameter, occipito-frontal diameter, abdominal circumference, and femur length using a two-stage approach. The first stage involved finding a suitable transformation of the raw fetal measurements (as the marginal distributions of ultrasound measurements were non-normal) to standardized deviations (Z-scores). In the second stage, a correlation model for a Gaussian process is fitted, yielding a correlation for any pair of observations made between 14 and 40 weeks. The correlation structure of the fetal Z-score can be used to assess whether the growth, for example, between successive measurements is satisfactory. The paper is accompanied by a Shiny application, see https://lxiao5.shinyapps.io/shinycalculator/ .

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Sonographic Reference Values for Fetal Transverse Cerebellar Diameter in the Second and Third Trimesters in a Nigerian Population

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479316687997 ◽

2017 ◽

Vol 33 (3) ◽

pp. 174-181 ◽

Cited By ~ 1

Author(s):

Charles Ugwoke Eze ◽

Queendaline Ebere Onwuzu ◽

Innocent Uchechukwu Nwadike

Keyword(s):

Reference Values ◽

Gestational Age ◽

Head Circumference ◽

Outer Margin ◽

Menstrual Period ◽

Last Menstrual Period ◽

Abdominal Circumference ◽

Femur Length ◽

Biparietal Diameter ◽

Nigerian Population

This study aimed to establish reference values of fetal transverse cerebellar diameter (TCD) in a Nigerian population. A cross-sectional convenience study was carried out between June 2013 and May 2014 in Enugu, Nigeria. The sonographic examinations were performed on 697 pregnant women with gestational ages between 14 and 40 weeks. The TCD measurements were obtained from the proximal outer margin to the distal outer margin of cerebellum. The women’s last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference were also recorded. The mean (standard deviation) TCD increased from 13.6 (2.2) mm to 27.3 (2.6) mm and 28.9 (2.0) mm to 42.9 (2.0) mm in the second and third trimesters, respectively. The relationship of TCD with gestational age obtained from last menstrual period, femur length, biparietal diameter, head circumference, and abdominal circumference was determined. The TCD had a strong correlation with gestational age ( r = .93; P < .05). Reference values for TCD were established for those patients who attended this clinic. This is a likely data set to use for future research that could focus on similar practices and in other regions of the country for possible generation of a nationwide nomogram.

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