scholarly journals Sex differences in fetal growth and immediate birth outcomes in a low-risk Caucasian population

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Sander Galjaard ◽  
Lieveke Ameye ◽  
Christoph C. Lees ◽  
Anne Pexsters ◽  
Tom Bourne ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Head Circumference ◽  
Growth Curves ◽  
First Trimester ◽  
Low Risk ◽  
Abdominal Circumference ◽  
Fetal Ultrasound ◽  
Crown Rump Length ◽  
Gender Specific

Abstract Background According to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes. Methods First, second, and third trimester fetal ultrasound examinations were conducted between 2002 and 2012. The data was selected using the following criteria: routine examinations in uncomplicated singleton pregnancies, Caucasian ethnicity, and confirmation of gestational age by a crown-rump length (CRL) measurement in the first trimester. Generalized Additive Model for Location, Scale and Shape (GAMLSS) was used to align the time frames of the longitudinal fetal measurements, corresponding with the methods of the postnatal growth curves of the WHO MGRS Group. Results A total of 27,680 complete scans were selected from the astraia© ultrasound database representing 12,368 pregnancies. Gender-specific fetal growth curves for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were derived. The HC and BPD were significantly larger in boys compared to girls from 20 weeks of gestation onwards (p < 0.001) equating to a 3-day difference at 20–24 weeks. Boys were significantly heavier, longer, and had greater head circumference than girls (p < 0.001) at birth. The Apgar score at 1 min (p = 0.01) and arterial cord pH (p < 0.001) were lower in boys. Conclusions These longitudinal fetal growth curves for the first time allow integration with neonatal and pediatric WHO gender-specific growth curves. Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls. Gender difference in intrauterine growth is sufficiently distinct to have a clinically important effect on fetal weight estimation but also on the second trimester dating. Therefore, these differences might already play a role in early fetal or immediate neonatal management.

scholarly journals Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalana M. Sol ◽  
Charissa van Zwol - Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
Maria-Pilar Martinez-Moral ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Head Circumference ◽  
Lower Risk ◽  
First Trimester ◽  
Population Based ◽  
Third Trimester ◽  
Bisphenol S ◽  
Fetal Head ◽  
Urine Concentrations

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.

scholarly journals The impact of optimal dating on the assessment of fetal growth

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Fries ◽  
F. Dhombres ◽  
M. Massoud ◽  
J. J. Stirnemann ◽  
R. Bessis ◽  
...  
Keyword(s):  
Fetal Growth ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Low Risk ◽  
Fetal Ultrasound ◽  
Cross Sectional ◽  
Growth Standards ◽  
Z Scores ◽  
The Impact ◽  
In Pregnancy

Abstract Background The impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated. Methods Nationwide cross-sectional study of routine fetal ultrasound biometry in low-risk pregnant women whose gestational age (GA) had been previously assessed by a first trimester CRL measurement. We compared the CRL-based GA according to the Robinson formula and the IG formula. We evaluated the fetal biometric measurements as well as the EFW taken later in pregnancy depending on the dating formula used. Mean and standard deviation of the Z scores as well as the number and percentage of cases classified as <3rd, < 10th, >90th and > 97th percentile were compared. Results Three thousand five hundred twenty-two low-risk women with scans carried out after 18 weeks were included. There were differences of zero, one and 2 days in 642 (18.2%), 2700 (76.7%) and 180 (5%) when GA was estimated based on the Robinson or the IG formula, respectively. The biometry Z scores assessed later in pregnancy were all statistically significantly lower when the Intergrowth-based dating formula was used (p < 10− 4). Likewise, the number and percentage of foetuses classified as <3rd, < 10th, >90th and > 97th percentile demonstrated significant differences. As an example, the proportion of SGA foetuses varied from 3.46 to 4.57% (p = 0.02) and that of LGA foetuses from 17.86 to 13.4% (p < 10− 4). Conclusion The dating formula used has a quite significant impact on the subsequent evaluation of biometry and EFW. We suggest that the combined and homogeneous use of a recent dating standard, together with prescriptive growth standards established on the same low-risk pregnancies, allows an optimal assessment of fetal growth.

scholarly journals The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP)

2018 ◽  
Vol 26 (7) ◽  
pp. 918-927 ◽  
Author(s):  
Chiara Di Gravio ◽  
Ashwin Lawande ◽  
Ramesh D. Potdar ◽  
Sirazul A. Sahariah ◽  
Meera Gandhi ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Maternal Age ◽  
Maternal Nutrition ◽  
First Trimester ◽  
Abdominal Circumference ◽  
Crown Rump Length ◽  
Fetal Biometry ◽  
Biparietal Diameter ◽  
Using Data ◽  
Newborn Size

Background: Young maternal age is associated with poorer birth outcomes, but the mechanisms are incompletely understood. Using data from a prospective cohort of pregnant women living in Mumbai slums, India, we tested whether lower maternal age was associated with adverse fetal growth. Methods: Fetal crown-rump length (CRL) was recorded at a median (interquartile range, IQR) of 10 weeks’ gestation (9-10 weeks). Head circumference (HC), biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC) were recorded at 19 (19-20) and 29 (28-30) weeks. Newborns were measured at a median (IQR) of 2 days (1-3 days) from delivery. Gestation was assessed using prospectively collected menstrual period dates. Results: The sample comprised 1653 singleton fetuses without major congenital abnormalities, of whom 1360 had newborn measurements. Fetuses of younger mothers had smaller CRL (0.01 standard deviation [SD] per year of maternal age; 95% confidence interval CI: 0.00-0.02 1 ; P = .04), and smaller HC, FL, and AC at subsequent visits. Fetal growth of HC (0.04 cm; 95% CI: 0.02-0.05; P < .001), BPD (0.01 cm; 95% CI: 0.00-0.01; P = .009), FL (0.04 cm; 95% CI: 0.02-0.06; P < .001), and AC (0.01 cm; 95% CI: 0.00-0.01; P = .003) up to the third trimester increased with maternal age. Skinfolds, head, and mid-upper arm circumferences were smaller in newborns of younger mothers. Adjusting for maternal prepregnancy socioeconomic status, body mass index, height, and parity attenuated the associations between maternal age and newborn size but did not change those with fetal biometry. Conclusion: Fetuses of younger mothers were smaller from the first trimester onward and grew slower, independently of known confounding factors.

scholarly journals The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study

2019 ◽  
Vol 16 (19) ◽  
pp. 3700 ◽  
Author(s):  
Leah Zilversmit Pao ◽  
Emily W. Harville ◽  
Jeffrey K. Wickliffe ◽  
Arti Shankar ◽  
Pierre Buekens
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Cumulative Risk ◽  
Logistic Models ◽  
Growth Curves ◽  
Adverse Outcomes ◽  
Risk Scores ◽  
Growth Study ◽  
Race Ethnicity ◽  
Pregnancy Weight

Metals, stress, and sociodemographics are commonly studied separately for their effects on birth outcomes, yet often jointly contribute to adverse outcomes. This study analyzes two methods for measuring cumulative risk to understand how maternal chemical and nonchemical stressors may contribute to small for gestational age (SGA). SGA was calculated using sex-specific fetal growth curves for infants of pregnant mothers (n = 2562) enrolled in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Study. The exposures (maternal lead, mercury, cadmium, Cohen’s perceived stress, Edinburgh depression scores, race/ethnicity, income, and education) were grouped into three domains: metals, psychosocial stress, and sociodemographics. In Method 1 we created cumulative risk scores using tertiles. Method 2 employed weighted quantile sum (WQS) regression. For each method, logistic models were built with three exposure domains individually and race/ethnicity, adjusting for age, parity, pregnancy weight gain, and marital status. The adjusted effect of overall cumulative risk with three domains, was also modeled using each method. Sociodemographics was the only exposure associated with SGA in unadjusted models ((odds ratio) OR: 1.35, 95% (confidence interval) CI: 1.08, 1.68). The three cumulative variables in adjusted models were not significant individually, but the overall index was associated with SGA (OR: 1.17, 95% CI: 1.02, 1.35). In the WQS model, only the sociodemographics domain was significantly associated with SGA. Sociodemographics tended to be the strongest risk factor for SGA in both risk score and WQS models.

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Tanya Maric ◽  
Natasha Singh ◽  
Keith Duncan ◽  
Guy J. Thorpe-Beeston ◽  
Makrina D. Savvidou
Keyword(s):  
Fetal Growth ◽  
Case Control Study ◽  
Subsequent Development ◽  
First Trimester ◽  
Case Control ◽  
Retrospective Case ◽  
Crown Rump Length ◽  
Significant Difference ◽  
Twin Pregnancies ◽  
Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

First‐Trimester Abdominal Circumference (Versus Crown Rump Length) Improves Precision in Inter‐ and Intraobserver Variability

2018 ◽  
Vol 38 (8) ◽  
pp. 2161-2167 ◽  
Author(s):  
Yalda Afshar ◽  
Rachel Gutkin ◽  
Deborah Krakow ◽  
Howard Cuckle ◽  
Neil S. Silverman ◽  
...  
Keyword(s):  
First Trimester ◽  
Abdominal Circumference ◽  
Intraobserver Variability ◽  
Crown Rump Length

scholarly journals Fetal growth in low-risk Indian population at a tertiary centre and its comparison with INTERGROWTH-21 standards: a prospective cohort study

2019 ◽  
Vol 8 (11) ◽  
pp. 4400
Author(s):  
Anoosha K. Ravi ◽  
Krishna Agarwal ◽  
Siddarth Ramji ◽  
Sreenivas Vishnubhatla
Keyword(s):  
Fetal Growth ◽  
Indian Population ◽  
Abdominal Ultrasound ◽  
Low Risk ◽  
Abdominal Circumference ◽  
Indian Women ◽  
Tertiary Centre ◽  
Biparietal Diameter ◽  
Z Scores ◽  
Experienced Operator

Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with the INTERGROWTH-21 standards.Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric measurements were taken within 12 hours of childbirth.Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7) as compared to INTERGROWTH-21 standards. From 1st through 5th visit, the z scores for BPD and HC improved whereas declined for AC and FL.Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to INTERGROWTH-21 standards.

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

2019 ◽  
Vol 19 (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.

scholarly journals 273.Insulin-like growth factor treatment of pregnant guinea pigs during early pregnancy promotes fetal growth

2004 ◽  
Vol 16 (9) ◽  
pp. 273
Author(s):  
A. N. Sferruzzi-Perri ◽  
J. A. Owens ◽  
J. S. Robinson ◽  
C. T. Roberts
Keyword(s):  
Growth Factor ◽  
Fetal Growth ◽  
Early Pregnancy ◽  
Guinea Pigs ◽  
Placental Weight ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Insulin Like Growth Factor ◽  
Crown Rump Length ◽  
Igf I

Insulin-like growth factor (IGF)-II is an important regulator of growth in many tissues and is abundantly expressed in the placenta during pregnancy. Gene ablation studies performed in mice have shown that IGF-II deficiency results in both impaired fetal and placental growth, whereas deficiency in IGF-I reduces fetal growth only. Conversely, maternal IGF supplementation in early pregnancy in the guinea pig increases placental and fetal size by mid pregnancy. This study aimed to determine whether these anabolic effects persist into late pregnancy after cessation of treatment. On Day 20 of pregnancy, mothers were anaesthetised and a mini osmotic pump was implanted subcutaneously, to deliver 1mg/kg/day IGF-I (n = 7), IGF-II (n = 9) or vehicle (n = 7) for 17 days. Guinea pigs were killed on Day 62 of pregnancy (term ~67 days). Fetal and placental weights, and maternal and fetal body composition, were measured. Total litter size was unaffected by IGF treatment; however, IGF-II increased the number of viable fetuses by 26% (P = 0.01). After adjusting for the number of viable pups per litter, maternal IGF treatment increased fetal growth by increasing abdominal circumference, crown-rump length and fetal weight (fetal weight: IGF-I 79+/–2.5 g; IGF-II 78+/–2.6 g; vs vehicle 68+/–2.5 g, P = 0.02). IGF treatment did not alter absolute or relative fetal organ weights. IGF-I reduced placental weight by 9% and IGF-II increased it by 9%, but not significantly. IGF-I increased the fetal weight�:�placental weight ratio (19+/–0.9 vs 15+/–0.9, respectively P = 0.043). IGF treatment did not affect maternal weight gain during pregnancy nor net carcass weight; however, IGF-I reduced maternal lung and adipose tissue weights. In conclusion, maternal IGF-II treatment during early pregnancy improved fetal growth into late gestation, possibly by modulating placental efficiency. As poor placental development is implicated in fetal growth restriction, increasing maternal IGF abundance in early to mid pregnancy may be a potential therapeutic approach to placental insufficiency.

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