Comparison of Fetal and Neonatal Growth Curves in Detecting Growth Restriction

Abstract

Objective To evaluate the outcome of intrauterine growth restriction (IUGR) infants with abnormal pulsatility index of the umbilical artery according to the neonatal birth weight/gestational age standards and the intrauterine growth charts. Methods We analyzed 53 pregnancies with severe IUGR classified as Group 2 (22 IUGR: abnormal pulsatility index and normal fetal heart rate) and Group 3 (31 IUGR: abnormal pulsatility index and fetal heart rate). Neonatal birth weight/gestational age distribution, body size measurements, maternal characteristics and obstetric outcome, and neonatal major and minor morbidity and mortality were compared with those obtained in 79 singleton pregnancies with normal fetal growth and pulsatility index, matched for gestational age [appropriate for gestational age (AGA) group]. Differences were analyzed with the χ2 test and the Student’s t test. Differences between means corrected for gestational age in the different groups were assessed by analysis of covariance test. A P value <0.05 was considered significant. Results At delivery, utilizing the neonatal standards, 25/53 (47%) IUGR showed a birthweight above the 10th percentile (IUGRAGA) whereas in 28, birthweight was below the 10th percentile (IUGRSGA). All body size measurements were significantly higher in AGA than in IUGRAGA and IUGRSGA. Forty-nine out of 79 (62%) AGA and 49/53 (92%) IUGR were admitted in the neonatal intensive care unit (p<0.001). One out of 79 (1%) AGA and 6/53 (11%) IUGR newborns died within 28 days (p<0.02). Major and minor morbidity was not different. Conclusion This study shows that neonatal outcome is similar in IUGR of the same clinical severity, whether or not they could be defined AGA or SGA according to the neonatal standards. Neonatal curves are misleading in detecting low birthweight infants and should be utilized only when obstetrical data are unavailable.

Shining light in dark corners: Diagnosis and management of late‐onset fetal growth restriction

“…40,41 These studies suggest that slowing of fetal growth is an important indicator of placental insufficiency, although the associations with adverse perinatal outcome are confounded by the presence of known risk factors, particularly SGA. [40][41][42] There are little data on the importance of slowing fetal growth among 'appropriate for gestational age' fetuses (i.e. birthweight >10th centile) in late pregnancy, yet it seems likely that as fetuses cross centiles, perinatal risk will increase.…”

The tissue and plasma concentration of polyols and sugars in sheep intrauterine growth retardation

“…23 These factors suggest that in PI-IUGR, changes in polyol metabolism and concentration may also exist. Given the important role polyols play in cell metabolism, the present study had as a goal to investigate maternal and fetal carbohydrate concentrations in the situation of PI-IUGR, with the aim of highlighting possible alterations in the metabolic pathways associated with polyol and sugar metabolism in PI-IUGR…”

Tuberculin conversion and leukocyte migration inhibition test after BCG vaccination in newborn infants

“…Babies weighing between 10 th to 90 th centile for weight at birth for a given gestational age were classified as appropriate-for-gestational age (AGA) and those weighing less than 10 th centile for a given gestational age at birth were classified as small-for-gestational age (SGA). 33 Babies born to mothers suffering from tuberculosis or receiving anti-tubercular drugs, ecclampsia, chronic infection, severe anemia (Hb < 7 g%), HIV positive, Hepatitis B positive, babies having clinical evidence of intrauterine infection, congenital malformations, undergoing exchange transfusion, severe birth asphyxia (Apgar score <3 at 1 min) and on prolonged medications were excluded from the study. Informed parental consent was obtained in all thus prepared were incubated in humid atmosphere at 37°C for 20 hours and the area of migration in control as well as antigen chambers was recorded on a centimeter graph paper fixed on a screen with the aid of an overhead projector.…”