Fetal growth rate and adverse perinatal events

Jong, C.L.D. de; Francis, André; Geijn, H.P. van; Gardosi, Jason

doi:10.1046/j.1469-0705.1999.13020086.x

Cited by 77 publications

(68 citation statements)

References 26 publications

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“…The present study aims to compare second-to thirdtrimester longitudinal growth assessment, by means of AC growth velocity [14,15] and conditional AC centiles [16], with cross-sectional evaluation at the third trimester for the prediction of LGA and macrosomia in an unselected population.…”

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confidence: 99%

Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population

et al. 2017

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Background: Prenatal detection of excessive growth remains inaccurate. Most strategies rely on a single cross-sectional evaluation of fetal size during the third trimester. Objectives: To compare second- to third-trimester longitudinal growth assessment with cross-sectional evaluation at the third trimester in the prediction of largeness for gestational age (LGA) and macrosomia. Methods: A cohort of 2,696 unselected singleton pregnancies scanned at 21 ± 2 and 32 ± 2 weeks was created. Abdominal circumference (AC) measurements were transformed to z values according to the INTERGROWTH-21st standards. Longitudinal growth assessment was performed by calculation of z velocity and conditional growth. Both methods were compared to cross-sectional assessment at 32 ± 2 weeks. Predictive performance for LGA and macrosomia was determined by receiver operating characteristic curve analysis. Result: A total of 188 (7%) newborns qualified for LGA and 182 (6.8%) for macrosomia. The areas under the curve (AUCs) for 32-week AC z score, AC z velocity, and conditional AC were 0.78, 0.61, and 0.55, respectively, for the prediction of LGA, and 0.75, 0.61, and 0.55, respectively, for the prediction of macrosomia. Both AUCs of AC z velocity and conditional AC were significantly lower (p < 0.001) than the AUC of cross-sectional AC z scores. Conclusions: In the general population, second- to third-trimester longitudinal assessment of fetal growth is inferior to third-trimester cross-sectional evaluation of size in the prediction of LGA and macrosomia.

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confidence: 99%

Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population

et al. 2017

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“…The estimated fetal weight at the prenatal sonogram closest to delivery was compared to the birth weight, using a correction factor of 30 g/d to account for interval growth; 30 g/d is the approximate amount of daily weight gain for a term fetus in the third trimester. [10][11][12] In addition, to take into account the possibility that fetuses with gastroschisis may grow more slowly than healthy fetuses, the estimated fetal weight was compared to the birth weight without using a correction factor for interval growth. In cases in which fetal growth was followed serially, only the last examination before delivery was used.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of Sonography to Predict Estimated Weight in Fetuses With Gastroschisis

Adams

Durfee

Pettigrew

et al. 2012

Journal of Ultrasound in Medicine

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“…De Jong showed in 1999 that the fetal growth rate was significantly lower in pregnancies that had operative delivery for presumed fetal distress (20.9 g/day) or neonatal unit admission (20.3 g/day) compared to those with uncomplicated outcome (21.9 g/day) [29]. A large screening study of 4,512 nulliparous woman recruited over a four year period in Cambridge UK [30] found that an EFW below the 10 th centile was associated with an increased risk of neonatal morbidity, but only if the fetal AC growth velocity was in the lowest decile (relative risk of 17.6).…”

Section: Assessment Of Fetal Growth At Termmentioning

confidence: 99%

Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term

Khalil

Thilaganathan

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

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Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) -a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. Doppler cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term. CPR is an independent predictor of intrapartum fetal distress, admission to the neonatal unit at term, stillbirth, perinatal death and neonatal morbidity. Raised uterine artery Doppler resistance in the third trimester is independently associated with significantly lower birthweight and CPR. The combination of the estimated fetal weight, CPR and uterine Doppler in the third trimester can identify the majority of fetuses at risk of stillbirth. HIGHLIGHTS Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, the majority of fetuses suffering from stillbirth at term are not small for gestational age. Serial measurements to assess growth velocity, combined with fetal Doppler, are preferable than a single point estimate. The cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term  The combination of the estimated fetal weight, CPR and uterine Doppler in the third trimester can identify the majority of fetuses at risk of stillbirth Highlights (for review) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 ABSTRACT Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) -a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. Doppler cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term. CPR is an independent predictor of intrapartum fetal distress, admission to the neonatal unit at term, stillbirth, perinatal death and neonatal morbidity. Raised uterine artery Doppler resistance in the third trimester is independently associated with significantly lower birthweight and CPR. The combination of the estimated fetal weight, CPR and uterine Doppler in the t...

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Fetal growth rate and adverse perinatal events

Abstract: Impaired fetal weight gain prior to birth is associated with adverse perinatal events suggestive of growth failure.

Cited by 77 publications

References 26 publications

Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population

Second- to Third-Trimester Longitudinal Growth Assessment for the Prediction of Largeness for Gestational Age and Macrosomia in an Unselected Population

Accuracy of Sonography to Predict Estimated Weight in Fetuses With Gastroschisis

Role of uteroplacental and fetal Doppler in identifying fetal growth restriction at term

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