The proper measure of intrauterine growth retardation is function, not size

Mahadevan, N.; Pearce, Malcolm; Steer, Philip

doi:10.1111/j.1471-0528.1994.tb13576.x

Cited by 18 publications

(8 citation statements)

References 29 publications

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“…A more general limit is our inability to identify non‐SGA infants who experienced growth faltering. SGA and FGR are not synonymous, and our false positive group undoubtedly included some infants with restricted growth, but with a birthweight above the 10th percentile. However, we do not believe that these infants constitute a large proportion of our false positive group, because population screening in France does not focus on the identification of growth faltering in the absence of small fetal size…”

Section: Discussionmentioning

confidence: 99%

“…In France, Belgium and Germany, a third trimester ultrasound for monitoring fetal growth is integrated into standard prenatal care, whereas, in the USA, UK, New Zealand and Canada, a third trimester ultrasound is recommended only for women with risk factors for FGR . Many recommendations and studies also acknowledge that FGR can be present in the absence of SGA, but these cases are not a principal focus of population screening…”

Section: Introductionmentioning

confidence: 99%

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Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Monier

Blondel

Ego

et al. 2014

BJOG

150

100

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Objective To assess the proportion of small for gestational age (SGA) and normal birthweight infants suspected of fetal growth restriction (FGR) during pregnancy, and to investigate obstetric and neonatal outcomes by suspicion of FGR and SGA status at birth.Design Population-based study.Setting All French maternity units in 2010.Population Representative sample of singleton births (n = 14 100).Methods We compared SGA infants with a birthweight of less than the 10th percentile suspected of FGR, defined as mention of FGR in medical charts (true positives), non-SGA infants suspected of FGR (false positives), SGA infants without suspicion of FGR (false negatives) and non-SGA infants without suspicion of FGR (true negatives). Multivariable analyses were adjusted for maternal and neonatal characteristics hypothesised to affect closer surveillance for FGR and our outcomes.Main outcome measures Obstetric management (caesarean, provider-initiated preterm and early term delivery) and neonatal outcomes (late fetal death, preterm birth, Apgar score, resuscitation at birth).Results 21.7% of SGA infants (n = 265) and 2.1% of non-SGA infants (n = 271) were suspected of FGR during pregnancy. Compared with true negatives, provider-initiated preterm deliveries were higher for true and false positives (adjusted risk ratio [aRR], 6.1 [95% CI,.7]), but not for false negatives (aRR, 1.1 [95% CI, 0.6-1.9]). Neonatal outcomes were not better for SGA infants if FGR was suspected.Conclusion Antenatal suspicion of FGR among SGA infants was low and one-half of infants suspected of FGR were not SGA. The increased risk of provider-initiated delivery observed in non-SGA infants suspected of FGR raises concerns about the iatrogenic consequences of screening.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Monier

Blondel

Ego

et al. 2014

BJOG

150

100

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show abstract

“…In our study also, data on birthweight or birth length were not predictive of cognitive outcome; there was a slight correlation only with respect to head circumference at birth. From a methodological viewpoint, and by analogy, with the extensive research on the developmental prognosis of preterm children, it is necessary to determine whether these parameters can be taken as causal risk factors with direct pathogenetic effect or whether they are instead risk markers associated only with the pathogenetic risk factors still unknown (Mahadevan et al 1994, Kraemer et al 1997.…”

Section: In Wechsler Intelligencementioning

confidence: 99%

Cognitive development in Silver‐Russell syndrome: a sibling‐controlled study

Noeker

Wollmann

2004

Develop Med Child Neuro

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This study examined cognitive development in Silver‐Russell syndrome (SRS), a condition with intrauterine growth retardation, persisting short stature, and specific stigmata. Neuropsychological function and cognitive abilities were assessed in a sample of 36 children with SRS (21 males, 15 females; mean age 7 years 6 months, SD 2 years 8 months; age range 3 to 12 years) and 25 normally developing siblings (mean age 8 years 6 months, SD 2 years 7 months; age range 3 to 12 years) using the Kaufman Assessment Battery for Children. Special measures were taken to control for confounding factors and sample bias. Mean overall IQ score in the total SRS sample (95.7, SD 10.63), as measured by the Mental Processing Composite Scale, was significantly reduced (p=0.021) compared with test norms (IQ 100, SD 15), indicating a moderate cognitive impairment. Subscale analysis revealed some specific deficiencies. However, these cannot be attributed to an established category of specific learning disorder. The mean score in the Achievement Scale (91.25, SD 14.92), which is more sensitive to educational influences, showed stronger deficits (p=0.001). The sibling control group achieved a slightly better mean IQ score (104.20, SD 12.32) than test norms (p=0.10). Direct analysis of paired differences between the subsample of children with SRS and a sibling among the control group (n=25) revealed a significant mean difference of 8.08 IQ points (p=0.011). Risk factor analysis revealed that cognitive development is not associated with birth length (p=0.404), birthweight (p=0.820), growth hormone therapy (p=0.810), phenotypic severity (p=0.828), or sex (p=0.880). Two children with maternal uniparental disomy for the entire chromosome 7 had markedly lower IQ scores (81 and 84 respectively). In contrast to the few previous findings, children with SRS show only moderate, but significant, impairments in cognitive outcome, which are more striking in our sample when compared with siblings than with test norms.

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“…This could be assisted by the use of individualised fetal measurement, rather than the use of cross‐sectional averages 35 . Individualised dynamic measurement would be even more effective 36,37 …”

Section: Neurochemical Characteristics Of Laryngeal Induced Apnoea Smentioning

confidence: 99%

Birth under water–to breathe or not to breathe

Johnson

1996

BJOG

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The proper measure of intrauterine growth retardation is function, not size

Cited by 18 publications

References 29 publications

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study

Cognitive development in Silver‐Russell syndrome: a sibling‐controlled study

Birth under water–to breathe or not to breathe

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