scholarly journals OP01.05: Reduced third trimester growth velocity in appropriate-for-gestational-age fetuses is associated with multiple indicators of placental insufficiency

2017 ◽  
Vol 50 ◽  
pp. 49-49
Author(s):  
T.M. MacDonald ◽  
L. Hui ◽  
S. Tong ◽  
A. Robinson ◽  
K. Dane ◽  
...  
Keyword(s):  
Gestational Age ◽  
Growth Velocity ◽  
Placental Insufficiency ◽  
Third Trimester ◽  
Multiple Indicators ◽  
Appropriate For Gestational Age

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

2007 ◽  
Vol 92 (7) ◽  
pp. 2758-2763 ◽  
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.

scholarly journals Perinatal Adverse Effects in Newborns with Estimated Loss of Weight Percentile between the Third Trimester Ultrasound and Delivery. The GROWIN Study

2021 ◽  
Vol 10 (20) ◽  
pp. 4643
Author(s):  
María Sonsoles Galán Arévalo ◽  
Ignacio Mahillo-Fernández ◽  
Luis Mariano Esteban ◽  
Mercedes Andeyro-García ◽  
Roi Piñeiro Pérez ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Late Gestation ◽  
Third Trimester ◽  
Loss Of Weight ◽  
Increased Risk ◽  
Appropriate For Gestational Age ◽  
Adverse Perinatal Outcomes ◽  
Weight Percentile

Fetal growth restriction has been associated with an increased risk of adverse perinatal outcomes (APOs). We determined the importance of fetal growth detention (FGD) in late gestation for the occurrence of APOs in small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) newborns. For this purpose, we analyzed a retrospective cohort study of 1067 singleton pregnancies. The newborns with higher APOs were SGA non-FGD and SGA FGD in 40.9% and 31.5% of cases, respectively, and we found an association between SGA non-FGD and any APO (OR 2.61; 95% CI: 1.35–4.99; p = 0.004). We did not find an increased APO risk in AGA FGD newborns (OR: 1.13, 95% CI: 0.80, 1.59; p = 0.483), except for cesarean delivery for non-reassuring fetal status (NRFS) with a decrease in percentile cutoff greater than 40 (RR: 2.41, 95% CI: 1.11–5.21) and 50 (RR: 2.93, 95% CI: 1.14–7.54). Conclusions: Newborns with the highest probability of APOs are SGA non-FGDs. AGA FGD newborns do not have a higher incidence of APOs than AGA non-FGDs, although with falls in percentile cutoff over 40, they have an increased risk of cesarean section due to NRFS. Further studies are warranted to detect these newborns who would benefit from close surveillance in late gestation and at delivery.

scholarly journals OP16.08: Prediction of small for gestational age: added contribution of second to third trimester growth velocity

2019 ◽  
Vol 54 (S1) ◽  
pp. 139-140
Author(s):  
R.J. Martinez‐Portilla ◽  
M. Giannone ◽  
M. Rial‐Crestelo ◽  
A. Cancemi ◽  
F. Figueras
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Velocity ◽  
Third Trimester

31 Fetal abdominal circumference growth velocity as a predictor of neonatal outcome and birth weight in appropriate-for-gestational-age neonates

2016 ◽  
Vol 6 (3) ◽  
pp. 192-193
Author(s):  
Manouk Hendrix ◽  
Sander Van Kuijk ◽  
Desire Kramer ◽  
Danilo Gavilanes ◽  
Marc Spaanderman ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Growth Velocity ◽  
Neonatal Outcome ◽  
Abdominal Circumference ◽  
Appropriate For Gestational Age

scholarly journals Appropriate-for-gestational-age infants who exhibit reduced antenatal growth velocity display postnatal catch-up growth

PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0238700 ◽  
Author(s):  
Emma J. McLaughlin ◽  
Richard J. Hiscock ◽  
Alice J. Robinson ◽  
Lisa Hui ◽  
Stephen Tong ◽  
...  
Keyword(s):  
Gestational Age ◽  
Growth Velocity ◽  
Appropriate For Gestational Age ◽  
Catch Up

scholarly journals Reduced growth velocity from the mid-trimester is associated with placental insufficiency in fetuses born at a normal birthweight

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Lucy M. Kennedy ◽  
Stephen Tong ◽  
Alice J. Robinson ◽  
Richard J. Hiscock ◽  
Lisa Hui ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Growth Velocity ◽  
Clinical Care ◽  
Unmet Need ◽  
Placental Insufficiency ◽  
Abdominal Circumference ◽  
Adaptation To Hypoxia ◽  
Fat Percentage ◽  
Increased Risk

Abstract Background Fetal growth restriction (FGR) due to placental insufficiency is a major risk factor for stillbirth. While small-for-gestational-age (SGA; weight < 10th centile) is a commonly used proxy for FGR, detection of FGR among appropriate-for-gestational-age (AGA; weight ≥ 10th centile) fetuses remains an unmet need in clinical care. We aimed to determine whether reduced antenatal growth velocity from the time of routine mid-trimester ultrasound is associated with antenatal, intrapartum and postnatal indicators of placental insufficiency among term AGA infants. Methods Three hundred and five women had biometry measurements recorded from their routine mid-trimester (20-week) ultrasound, at 28 and 36 weeks’ gestation, and delivered an AGA infant. Mid-trimester, 28- and 36-week estimated fetal weight (EFW) and abdominal circumference (AC) centiles were calculated. The EFW and AC growth velocities between 20 and 28 weeks, and 20–36 weeks, were examined as predictors of four clinical indicators of placental insufficiency: (i) low 36-week cerebroplacental ratio (CPR; CPR < 5th centile reflects cerebral redistribution—a fetal adaptation to hypoxia), (ii) neonatal acidosis (umbilical artery pH < 7.15) after the hypoxic challenge of labour, (iii) low neonatal body fat percentage (BF%) reflecting reduced nutritional reserve and (iv) placental weight < 10th centile. Results Declining 20–36-week fetal growth velocity was associated with all indicators of placental insufficiency. Each one centile reduction in EFW between 20 and 36 weeks increased the odds of cerebral redistribution by 2.5% (odds ratio (OR) = 1.025, P = 0.001), the odds of neonatal acidosis by 2.7% (OR = 1.027, P = 0.002) and the odds of a < 10th centile placenta by 3.0% (OR = 1.030, P < 0.0001). Each one centile reduction in AC between 20 and 36 weeks increased the odds of neonatal acidosis by 3.1% (OR = 1.031, P = 0.0005), the odds of low neonatal BF% by 2.8% (OR = 1.028, P = 0.04) and the odds of placenta < 10th centile by 2.1% (OR = 1.021, P = 0.0004). Falls in EFW or AC of > 30 centiles between 20 and 36 weeks were associated with two–threefold increased relative risks of these indicators of placental insufficiency, while low 20–28-week growth velocities were not. Conclusions Reduced growth velocity between 20 and 36 weeks among AGA fetuses is associated with antenatal, intrapartum and postnatal indicators of placental insufficiency. These fetuses potentially represent an important, under-recognised cohort at increased risk of stillbirth. Encouragingly, this novel fetal assessment would require only one additional ultrasound to current routine care, and adds to the potential benefits of routine 36-week ultrasound.

scholarly journals Evaluation of the selected parameters of the fetal diastolic functions in normally grown or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control

2022 ◽  
pp. 1-7
Author(s):  
Seçil Karaca Kurtulmus ◽  
Ebru Sahin Gülec ◽  
Mustafa Sengül
Keyword(s):  
Glycaemic Control ◽  
Pulmonary Vein ◽  
Gestational Age ◽  
Pulsatility Index ◽  
Ductus Venosus ◽  
Control Group ◽  
Third Trimester ◽  
Poor Glycaemic Control ◽  
Appropriate For Gestational Age ◽  
Diabetic Mothers

Abstract Objective: This study aimed to investigate whether the third trimester fetal cardiac diastolic function measured by selected conventional Doppler indices is affected in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control. Methods: This cross-sectional study included 93 pregnant women divided into two groups. Group 1 included 45 appropriate-for-gestational-age or macrosomic fetuses from gestational diabetic mothers with poor glycaemic control (study group). Group 2 included 48 appropriate-for-gestational-age fetuses from gestational age-matched healthy mothers (control group). Functional fetal cardiac parameters and fetoplacental Doppler parameters were measured. Data were compared between the two groups. Results: Maternal characteristics did not differ significantly between the study and the control group. There were no significant differences in the early and late velocity, early/late velocity ratio of both mitral and tricuspid valves, the fetal pulmonary vein pulsatility index, and the ductus venosus pulsatility index between the study and the control group. Moreover, the rate of abnormal Doppler findings in pulmonary vein (pulmonary vein pulsatility index >95th centile), ductus venosus (ductus venosus pulsatility index >95th centile), and peripheral vessels (umbilical artery pulsatility index >95th centile, middle cerebral artery pulsatility index <5th centile, cerebra-placental index >95th centile) were comparable in both groups. Conclusions: The third trimester fetal diastolic functions measured by selected conventional Doppler techniques do not seem to be altered in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers who have poor glycaemic control.

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