Abstract
Physiologic interindividual differences in neonatal size are traditionally thought of as determined by differences in fetal growth occurring only in the second half of pregnancy. Whether possible differences in early intrauterine growth velocity are the effect of random growth fluctuations or may affect size at birth is still debated. This article aims at evaluating to what extent differences in neonatal size are accounted for by differences in fetal growth velocity. We analyzed the fetal growth of 130 healthy singletons for whom head (HC) and abdomen (AC) circumferences and femur diaphysis length (FDL) longitudinal profiles were available, together with the measures of weight (BW), length (BL), and head circumference (BHC) at birth. Individual profiles were fitted with ad-hoc models. Neonatal traits were transformed into standard deviation scores (SDS). Neonates in the upper third of BW-SDS distribution (3618 ± 43 g, mean ± SEM) had, at 22 wk of gestational age, AC growth velocity higher by 0.55 ± 0.10 mm/wk than those in the lower third (2902 ± 36 g). Neonates in the upper third of BL-SDS distribution (51.7 ± 0.21 cm) had, at 20 wk, FDL growth velocity higher by 0.11 ± 0.05 mm/wk than those in the lower third (48.2 ± 0.18 cm). Neonates in the upper third of BHC-SDS distribution (35.7 ± 0.13 cm) had, at 18 wk, HC growth velocity higher by 0.57 ± 0.20 mm/wk than those in the lower third (33.3 ± 0.11 cm). The differences in growth velocity remain constant throughout the second and third trimester for AC, and tend to vanish in the third trimester for HC and FDL. The differences in fetal growth velocity, which in our study were observed as early as mo 4, suggest that the genetic component plays an important role in fetal growth and is precociously expressed.
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Abbreviations
- AC:
-
abdomen circumference
- BHC:
-
head circumference at birth
- BL:
-
birth length
- BPD:
-
biparietal diameter
- BW:
-
birth weight
- CRL:
-
crown–rump length
- FDL:
-
femur diaphysis length
- GA:
-
gestational age
- HC:
-
head circumference
- SDS:
-
standard deviation score
References
Gluckman PD, Liggings GC 1984 Regulation of fetal growth. In: Beard RW, Nathanielsz PW (eds) Fetal Physiology and Medicine: The Basis of Perinatology, 2nd Ed, Vol VI. Marcel Dekker, New York, pp 511–558
Carrera JM, Devesa R, Carrera M, Serra B 1998 Regulating factors. In: Kurjak A (ed) Textbook of Perinatal Medicine. Parthenon Publishing Group Ltd, London, pp 1132–1139
Degani S 2001 Fetal biometry: clinical, pathological, and technical considerations. Obstet Gynecol Surv 56: 59–167
Bertino E, Di Battista E, Bossi A, Pagliano M, Fabris C, Aicardi G, Milani S 1996 Fetal growth velocity: kinetic, clinical, and biological aspects. Arch Dis Child 74: 10–F15
Blaas HG, Eik-Nes SH, Bremnes JB 1998 The growth of the human embryo. A longitudinal biometric assessment from 7 to 12 weeks of gestation. Ultrasound Obstet Gynecol 12: 46–354
Deter RL, Buster JE, Casson PR, Carson SA 1999 Individual growth patterns in the first trimester: evidence for difference in embryonic and fetal growth rates. Ultrasound Obstet Gynecol 13: 0–98
Guihard-Costa AM, Droullé P, Thiebaugeorges O, Hascoet JM 2000 A longitudinal study of fetal growth variability. Biol Neonate 78: 8–12
Benso L, Aicardi G, Fabris C, Milani S 1999 What longitudinal studies can tell us about fetal growth. In: Johnston FE, Zemel B, Eveleth P (eds) Human Growth in Context. Smith-Gordon, London, pp 41–50
International Federation of Gynecology and Obstetrics (FIGO) Sub-committee on Perinatal Epidemiology and Health Statistics 1984 Report of the committee following a workshop on the methodology of measurement and recording of infant growth in the perinatal period. FIGO, London
Robinson HP 1973 Sonar measurement of fetal crown-rump length as means of assessing maturity in first trimester of pregnancy. BMJ 4: 8–31
Todros T, Ferrazzi E, Groli C, Nicolini U, Parodi L, Pavoni M, Zorzoli A, Zucca S 1987 Fitting growth curves to head and abdomen measurements of the fetus: a multicentric study. J Clin Ultrasound 15: 5–105
Bertino E, Murru P, Bagna R, Ventriglia A, Garzena E, Martano C, Prandi G, Costa S, Borgione G, Milani S, Fabris C 1999 Standard antropometrici neonatali dell'Italia Nord-Occidentale. Riv Ital Pediatr 25: 99–906
Smith GCS, Smith MFS, McNay MB, Fleming JEE 1998 First-trimester growth and the risk of low birth weight. N Engl J Med 339: 817–1822
Pedersen JF, Mølsted-Pedersen L 1979 Early growth retardation in diabetic pregnancy. BMJ 1: 8–19
Reljič M 2001 The significance of crown-rump length measurement for predicting adverse pregnancy outcome of threatened abortions. Ultrasound Obstet Gynecol 17: 10–512
Kalish RB, Chasen ST, Gupta M, Sharma G, Perni SC, Chervenak FA 2003 First trimester prediction of growth discordance in twin gestations. Am J Obstet Gynecol 189: 06–709
Mul T, Mongelli M, Gardosi J 1996 A comparative analysis of second-trimester ultrasound dating formulae in pregnancies conceived with artificial reproductive techniques. Ultrasound Obstet Gynecol 8: 97–402
Mongelli M, Yuxin NG, Biswas A, Chew S 2003 Accuracy of ultrasound dating formulae in the late second-trimester in pregnancies conceived with in-vitro fertilization. Acta Radiol 44: 52–455
Vik T, Vatten L, Jacobsen G, Bakketeig LS 1997 Prenatal growth in symmetric and asymmetric small-for-gestational-age infants. Early Hum Dev 48: 67–176
Nakling J, Backe B 2002 Adverse obstetric outcome in fetuses that are smaller than expected at second trimester routine ultrasound examination. Acta Obstet Gynecol Scand 81: 46–851
Hindmarsh PC, Geary MPP, Rodeck CH, Kingdom JCP, Cole TJ 2002 Intrauterine growth and its relationship to size and shape at birth. Pediatr Res 52: 63–268
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Milani, S., Bossi, A., Bertino, E. et al. Differences in Size at Birth Are Determined by Differences in Growth Velocity during Early Prenatal Life. Pediatr Res 57, 205–210 (2005). https://doi.org/10.1203/01.PDR.0000148452.98518.D5
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DOI: https://doi.org/10.1203/01.PDR.0000148452.98518.D5
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