Fetal growth is directly related to maternal anthropometry and placental volume

Abstract

Objective: To describe the influence of maternal weight and weight gain, placental volume and the rate of placental growth in early pregnancy on fetal dimensions measured sonographically. Design: In a prospective study, 712 women were recruited from the antenatal clinic of the University Hospital of the West Indies. Data analysis was confined to 374 women on whom measurements of the placental volume at 14, 17 and 20 weeks gestation were complete. Measurements of maternal anthropometry and fetal size (by ultrasound) were performed. Weight gain in pregnancy between the first antenatal visit (8-10 weeks) and 20 weeks gestation, and the rate of growth of the placenta between 14-17 and 17-20 weeks gestation were calculated. Main outcome measures: Fetal anthropometry (abdominal and head circumferences, femoral length, and biparietal diameter) at 35 weeks gestation. Results: Lower maternal weight at the first antenatal visit was associated with a significantly smaller placental volume at 17 and 20 weeks gestation (Po0.002 and o0.0001 respectively). In all women, maternal weight gain was directly related to fetal anthropometry. Placental volume at 14 weeks gestation and the rate of growth of the placenta between 17 and 20 weeks gestation were significantly related to all four fetal measurements. Conclusion: This study has provided evidence that both placental volume, and the rate of placental growth may influence fetal size. These effects are evident in the first half of pregnancy, and appear to be mediated through maternal weight and weight gain. Sponsorship: This study was supported by a grant from the Wellcome Trust,

Placental Volumetry by 2-D Sonography with a New Mathematical Formula: Prospective Study on the Shell of a Spherical Sector Model

“…Our results suggest that placenta grows following an S-shaped (Kozinszky and Suranyi 2012) or an exponential line during gestation between 9 and 29 weeks of gestation, which is in accordance with other literature results producing S-shaped or nearly exponential placental birthweight nomograms in the third trimester (Almog et al 2011;Thame et al 2001;Thame et al 2004). The placental volume increases from a median of 22 cm 3 at about 9 weeks of gestation to 490 cm 3 at about 28 weeks of gestation, which corresponds to a previous study (Derwig et al 2011).…”

“…Salafia et al (2006) suggested that large placenta relative to the fetal weight might represent placental insufficiency with reduced ability to maintain fetal growth. Thus, sonographic estimation of the placental growth in addition to the fetal growth is an important perinatal predictive indicator (Gassner et al 2003;Hafner et al 1998;Odibo et al 2011;Salafia et al 2006;Thame et al 2001;Thame et al 2004) and might be an adjunct modality of uteroplacental flow (Rotmensch et al 1994). These facts underline the necessity of routine placental volumetry in everyday practice.…”

“…Fetal birthweight correlates directly to placental weight at birth (Thame et al 2001;Thame et al 2004). A small-for-gestational-age (SGA) neonate has a placenta with reduced weight and volume compared to the appropriate-for-gestational-age (AGA) counterpart (Derwig et al 2011;Plasencia et al 2011) suggesting that the adequate fetal growth depends essentially on the placental expansion.…”

“…Prediction of the intrauterine growth retardation (IUGR) (Derwig et al 2011;Thame et al 2004) as well as pregnancies with other adverse outcomes (Gassner et al 2003;Metzenbauer et al 2002;Odibo et al 2011) is a major obstetrical problem (Salafia et al 2006). Importantly, an increasing amount of evidence demonstrates that the neonatal birthweight can be predicted significantly by placental volumetry during early to midpregnancy (Derwig et al 2013) using three dimensional (3-D) sonography (Collins et al 2013;Gassner et al 2003;Metzenbauer et al 2002;Odibo et al 2011;Plasencia et al 2011;Plasencia et al 2012;Rizzo et al 2012).…”

Maternal lean body mass may be the major determinant of birth weight: a study from India

“…It is well established that maternal nutritional status has a significant influence on the birth weight of the baby (Kramer, 1987;Naidu and Rao, 1994;Thame et al, 2004). Studies from India and other parts of the world have demonstrated the role of pre-pregnant weight and weight gain during pregnancy on the fetal size (Raman et al, 1995;Ehrenberg et al, 2003;Ronnenberg et al, 2003).…”