Individualized Norms of Optimal Fetal Growth: Fetal Growth Potential

Should We Customize Fetal Growth Standards?

“…Apart from the length of gestation, fetal growth is significantly influenced by many other fetal and maternal physiological factors such as sex, parity, maternal height and weight and ethnicity. The effect of fetal gender on birth weight differs across studies (232-310 g at 280 days) [21][22][23][24][25][26][27][28] . Most of this variability is secondary to absolute differences in the average birth weight of the population on which each study was carried out.…”

222: Birth weight, breast cancer and the potential mediating hormonal environment

“…The association between large infant birth weight and breast cancer was also essentially unaffected by adjustments for traditional breast cancer risk factors. The variables included in the propensity score are potential confounders related to both the birth weights and the risk of breast cancer [6,23,[34][35][36]. Inclusion of hormone replacement therapy is due to predisposition of women with high body mass index to menopausal symptoms and thus use of hormone replacement as well as to giving birth to large birth weight infants [37].…”

“…Growth potential norms account for physiologic and pathologic factors affecting fetal growth including gestational age, maternal weight, height, race/ethnicity, parity, education, marital status, smoking status and reproductive technologies assisted conception, characteristics associated with both birth weight and risk of breast cancer [23]. The growth potential norms were not adjusted for maternal concentrations of studied hormones.…”

“…Breast cancer risk factors weight, height, race and ethnicity, parity and smoking are associated with infant's birth weight, maternal concentrations of E3, AFP and PAPP-A and are also breast cancer risk factors [21,22]. Use of fetal growth potential norms to measure infant's birth weight would allow to account for the potential confounding effect of those variables on the birth weight [23]. Considering these findings, we hypothesized that women's risk of breast cancer is related to the birth weight of her infant, independently of her own birth weight and breast cancer risk factors and that the association is mediated by an adverse hormonal environment in the maternal circulation reflected by elevated E3/AFP ratio and PAPP-A concentration.…”

New aspect in management of fetal growth restriction

“…만삭 훨씬 전에 발생한 태아발육제한에서는 생물리학 계 수의 이상소견이 발생하기 전에 태반 순환의 부전, 혈류의 재분배 등이 일어나므로, 자궁동맥 및 제대 동맥 도플러 검사가 태반의 상태를 알아 보는 선별적 검사로 사용되고 있다 [28,29]. 많은 혈청 표지자들이 태아성장이나 태반기능과의 연관에 대해 보고 되고 있는데, 알파태아단백(alpha-fetoprotein), 임신-관련 혈청단백질-A (pregnancy-associated plasma protein-A), 융모성 성선자극 호르몬 (human chorionic gonadotrophin), 에스트리올(estriol), 인히빈-A (inhibin-A) 등은 염색체 이상뿐만 아니라 태아발육제한이나 임신 합병증과도 관련이 있다 [30][31][32]. 최근에는 vascular endothelial growth factor (VEGF), placenta growth factor (PlGF), soluble human vascular endothelial growth factor receptor-1 (sVEGFR-1), soluble endoglin 등이 조발형 (early-onset) 태아발육제한과 연관이 있다고 보고되었다 [33][34][35].…”