Fetal growth velocity: the NICHD fetal growth studies

Grantz, Katherine L.; Kim, Sungduk; Grobman, William A.; Newman, Roger B.; Owen, John; Skupski, Daniel; Grewal, Jagteshwar; Chien, Edward K.; Wing, Deborah A.; Wapner, Ronald J.; Ranzini, Angela C.; Nageotte, Michael P.; Hinkle, Stefanie; Pugh, Sarah; Li, Hanyun; Fuchs, Karin; Hediger, Mary L.; Louis, Germaine M. Buck; Albert, Paul S.

doi:10.1016/j.ajog.2018.05.016

Cited by 71 publications

(78 citation statements)

References 23 publications

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“…International percentile curves for EFW, calculated after studies of fetuses in Anglo-Saxon countries and used to check the week-adapted weight of the unborn fetuses worldwide, may not be the right strategy because they pursue a one-size-fits-all policy in approaching what is too large or too small [25, 26].…”

Section: Discussionmentioning

confidence: 99%

“…Goetzinger et al reported a lack of accuracy in fetal weight estimation when using Leopold’s manoeuvres [35]. Several prospective studies were able to show advantages of clinical palpation like Leopold’s manoeuvres in predicting fetal macrosomia [14, 26, 36, 37], and the accuracy of fetal weight estimation when using ultrasound biometry has been shown to be no better than that of Leopold’s manoeuvres [21]. Still other studies report an advantage for them for fetal weight estimation [38–44].…”

Section: Discussionmentioning

confidence: 99%

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Fetal weight estimation at term – ultrasound versus clinical examination with Leopold’s manoeuvres: a prospective blinded observational study

Preyer

Husslein

Concin

et al. 2019

BMC Pregnancy Childbirth

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Background Fetal weight estimation is of key importance in the decision-making process for obstetric planning and management. The literature is inconsistent on the accuracy of measurements with either ultrasound or clinical examination, known as Leopold’s manoeuvres, shortly before term. Maternal BMI is a confounding factor because it is associated with both the fetal weight and the accuracy of fetal weight estimation. The aim of our study was to compare the accuracy of fetal weight estimation performed with ultrasound and with clinical examination with respect to BMI. Methods In this prospective blinded observational study we investigated the accuracy of clinical examination as compared to ultrasound measurement in fetal weight estimation, taking the actual birth weight as the gold standard. In a cohort of all consecutive patients who presented in our department from January 2016 to May 2017 to register for delivery at ≥37 weeks, examination was done by ultrasound and Leopold’s manoeuvres to estimate fetal weight. All examiners (midwives and physicians) had about the same level of professional experience. The primary aim was to compare overall absolute error, overall absolute percent error, absolute percent error > 10% and absolute percent error > 20% for weight estimation by ultrasound and by means of Leopold’s manoeuvres versus the actual birth weight as the given gold standard, namely separately for normal weight and for overweight pregnant women. Results Five hundred forty-three patients were included in the data analysis. The accuracy of fetal weight estimation was significantly better with ultrasound than with Leopold’s manoeuvres in all absolute error calculations made in overweight pregnant women. For all error calculations performed in normal weight pregnant women, no statistically significant difference was seen in the accuracy of fetal weight estimation between ultrasound and Leopold’s manoeuvres. Conclusions Data from our prospective blinded observational study show a significantly better accuracy of ultrasound for fetal weight estimation in overweight pregnant women only as compared to Leopold’s manoeuvres with a significant difference in absolute error. We did not observe significantly better accuracy of ultrasound as compared to Leopold’s manoeuvres in normal weight women. Further research is needed to analyse the situation in normal weight women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fetal weight estimation at term – ultrasound versus clinical examination with Leopold’s manoeuvres: a prospective blinded observational study

Preyer

Husslein

Concin

et al. 2019

BMC Pregnancy Childbirth

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“…Inclusion criteria included maternal age 18–40 years; pre-gravid body mass index (BMI) 19.0–29.9 kg/m 2 calculated from recalled pre-pregnancy weight and height; viable singleton pregnancy between 8 weeks 0 days (8w0d) to 13 weeks 6 days with gestational age consistent with the last menstrual period dating within a prescribed range per screening sonogram. Women with prior adverse pregnancy outcomes, history of chronic disease, conception using medical drugs or assisted reproductive technology, cigarette smoking, illicit drug use or intake of ≥1 alcoholic drinks per day were excluded, as previously described [ 2 , 4 ]. For the Fetal Growth Standard, we also excluded women with pregnancy complications, including preterm delivery (<37 weeks), gestational diabetes, and hypertensive diseases, as well as neonatal conditions including congenital anomalies and death [ 2 ].…”

Section: Methodsmentioning

confidence: 99%

“…The NICHD Fetal Growth Studies–Singletons was a prospective cohort study designed to establish standards of fetal growth and determine the need for racial/ethnic specific standards [ 2 ]. Significant racial/ethnic differences in fetal growth, fetal growth velocity, and birthweight were observed even after adjusting for detailed demographic and socioeconomic factors that differed among the groups including insurance, annual income, education, and marital status [ 3 , 4 ]. However, whether race/ethnic differences in birthweight varied by these socioeconomic factors was not directly assessed.…”

Section: Introductionmentioning

confidence: 99%

Maternal Socioeconomic Factors and Racial/Ethnic Differences in Neonatal Anthropometry

Lambert

Gleason

Pugh

et al. 2020

IJERPH

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Disparities in birthweight by maternal race/ethnicity are commonly observed. It is unclear to what extent these disparities are correlates of individual socioeconomic factors. In a prospective cohort of 1645 low-risk singleton pregnancies included in the NICHD Fetal Growth Study (2009–2013), neonatal anthropometry was measured by trained personnel using a standard protocol. Socioeconomic characteristics included employment status, marital status, health insurance, annual income, and education. Separate adjusted generalized linear models were fit to both test the effect of race/ethnicity and the interaction of race/ethnicity and socioeconomic characteristics on neonatal anthropometry. Mean infant birthweight, length, head circumference, and abdominal circumference all differed by race/ethnicity (p < 0.001). We observed no statistically significant interactions between race/ethnicity and full-time employment/student status, marital status, insurance, or education in association with birthweight, neonatal exam weight, length, or head or abdominal circumference at examination. The interaction between income and race/ethnicity was significant only for abdominal circumference (p = 0.027), with no other significant interactions for other growth parameters, suggesting that racial/ethnic differences in neonatal anthropometry did not vary by individual socioeconomic factors in low-risk women. Our results do not preclude structural factors, such as lifetime exposure to poverty, as an explanation for racial/ethnic disparities.

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“…Among these studies or other reports, birthweight or its cross-sectional standardized score of body size has been generally utilized for fetal growth assessment. Although there is no objection that birthweight is indeed a valuable parameter, recent studies have shown that growth velocity provides additional information over knowing fetal size alone 4,5 . Considering the biological aspect, fetal growth velocity reflects the fetal response to various conditions during the developmental process within the maternal constraint 1,6 .…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity in fetal growth velocity

Sato

Matsuda

2019

Sci Rep

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Fetal growth quality is associated with susceptibility to non-communicable diseases. Fetal size has been conventionally assessed using the averaged growth chart, but fetal growth velocity has recently been attracting attention as another important aspect of fetal development. Since fetal growth velocity may reflect fetal response to various conditions during the developmental process within the maternal constraint, it is reasonable to imagine that there might exist a physiological diversity in growth velocity patterns over time, which has never been explored. We conducted a retrospective cohort study designed to evaluate the heterogeneity of fetal growth velocity in singleton pregnancies in the Japanese population. We leveraged the high frequency of prenatal checkup to collect large numbers of ultrasound measurements of every fetus (N = 801) and computationally analyzed individual changes in growth per week. Latent class trajectory analysis identified three distinct velocity patterns. The variation in growth velocity appeared in the third trimester and corresponded to the differences in neonatal size. This heterogeneity was not simply explained by maternal factors and fetal sex, although those factors had time-varying effects on fetal size. Our findings regarding the heterogeneity in fetal growth velocity will aid in the comprehensive understanding of fetal development quality.

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Fetal growth velocity: the NICHD fetal growth studies

Abstract: We provide fetal growth velocity data to complement our previous work on fetal growth size standards, and have developed a calculator to compute fetal growth velocity. Preliminary findings suggest that growth velocity adds additional information over knowing fetal size alone.

Cited by 71 publications

References 23 publications

Fetal weight estimation at term – ultrasound versus clinical examination with Leopold’s manoeuvres: a prospective blinded observational study

Fetal weight estimation at term – ultrasound versus clinical examination with Leopold’s manoeuvres: a prospective blinded observational study

Maternal Socioeconomic Factors and Racial/Ethnic Differences in Neonatal Anthropometry

Heterogeneity in fetal growth velocity

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