Reduced growth velocity from the mid-trimester is associated with placental insufficiency in fetuses born at a normal birthweight
| العنوان: | Reduced growth velocity from the mid-trimester is associated with placental insufficiency in fetuses born at a normal birthweight |
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| المؤلفون: | Teresa M. MacDonald, Susan P. Walker, Anna Middleton, Lisa Hui, Richard Hiscock, Lucy M Kennedy, Alice J. Robinson, Kirsten M. Dane, Stephen Tong |
| المصدر: | BMC Medicine BMC Medicine, Vol 18, Iss 1, Pp 1-14 (2020) |
| بيانات النشر: | BioMed Central, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Birth weight, Ideal Body Weight, lcsh:Medicine, Gestational Age, Placental insufficiency, Ultrasonography, Prenatal, Umbilical Arteries, Cohort Studies, Fetal Development, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Small-for-gestational-age, Pregnancy, Risk Factors, medicine, Birth Weight, Humans, 030212 general & internal medicine, Appropriate-for-gestational-age, Growth velocity, Fetus, 030219 obstetrics & reproductive medicine, Fetal Growth Retardation, Obstetrics, business.industry, lcsh:R, Fetal growth restriction, Infant, Newborn, Gestational age, General Medicine, medicine.disease, Placental Insufficiency, Adaptation, Physiological, Antenatal ultrasonography, Fetal Weight, Relative risk, Pregnancy Trimester, Second, Cohort, Small for gestational age, Female, business, Mid-trimester, Research Article |
| الوصف: | Background Fetal growth restriction (FGR) due to placental insufficiency is a major risk factor for stillbirth. While small-for-gestational-age (SGA; weight Methods Three hundred and five women had biometry measurements recorded from their routine mid-trimester (20-week) ultrasound, at 28 and 36 weeks’ gestation, and delivered an AGA infant. Mid-trimester, 28- and 36-week estimated fetal weight (EFW) and abdominal circumference (AC) centiles were calculated. The EFW and AC growth velocities between 20 and 28 weeks, and 20–36 weeks, were examined as predictors of four clinical indicators of placental insufficiency: (i) low 36-week cerebroplacental ratio (CPR; CPR Results Declining 20–36-week fetal growth velocity was associated with all indicators of placental insufficiency. Each one centile reduction in EFW between 20 and 36 weeks increased the odds of cerebral redistribution by 2.5% (odds ratio (OR) = 1.025, P = 0.001), the odds of neonatal acidosis by 2.7% (OR = 1.027, P = 0.002) and the odds of a P P = 0.0005), the odds of low neonatal BF% by 2.8% (OR = 1.028, P = 0.04) and the odds of placenta P = 0.0004). Falls in EFW or AC of > 30 centiles between 20 and 36 weeks were associated with two–threefold increased relative risks of these indicators of placental insufficiency, while low 20–28-week growth velocities were not. Conclusions Reduced growth velocity between 20 and 36 weeks among AGA fetuses is associated with antenatal, intrapartum and postnatal indicators of placental insufficiency. These fetuses potentially represent an important, under-recognised cohort at increased risk of stillbirth. Encouragingly, this novel fetal assessment would require only one additional ultrasound to current routine care, and adds to the potential benefits of routine 36-week ultrasound. |
| اللغة: | English |
| تدمد: | 1741-7015 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0affab4e1ca06a39b0091cc220560032Test http://europepmc.org/articles/PMC7758928Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0affab4e1ca06a39b0091cc220560032 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17417015 |
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