Fetal Growth Pattern and Prediction of Low Birth Weight in Gastroschisis

Abstract

Objectives: To examine growth patterns and predictions of low birth weight in gastroschisis fetuses. Methods: This is a retrospective study of isolated fetal gastroschisis before week 24. Ultrasound fetal biometric parameters - head circumference (HC), abdominal circumference (AC), femur length, HC/AC ratio and estimated fetal weight (EFW) - were plotted against normal growth charts. The percentage difference in mean values between normal and gastroschisis fetuses was determined. The growth deficit for each ultrasound parameter was calculated for the fetuses with 1 examination in each designated period (period I: weeks 20-25⁺⁶; period II: weeks 26-31⁺⁶; period III: from week 32 until term). For low birth weight prediction, measurements below the 10th percentile in periods I and II were tested. Results: Seventy pregnancies were examined. For all fetal parameters, the mean measurements were lower in fetuses with gastroschisis (p < 0.005). The EFW revealed an increased growth deficit between the periods (p = 0.030). HC was predictive of low birth weight in period II (OR = 6.07; sensitivity = 70.8%; specificity = 71.4%). Conclusions: Fetuses with gastroschisis present a reduced growth pattern, and it appears that no growth recovery occurs after the growth restriction has been established. Between week 26 and week 31⁺⁶, an HC measurement below the 10th percentile is associated with an increased risk of low birth weight.

Association between maternal passive smoking and increased risk of delivering small-for-gestational-age infants at full-term using plasma cotinine levels from The Hokkaido Study: a prospective birth cohort

“…The second strength was that we measured cotinine levels at the 8th month of pregnancy because we know that birth size reduction is related to maternal smoking during the third trimester 48. The 4–8th month of pregnancy represents the critical window of maternal exposure to chemicals leading to low birth weight,49 fetal growth is the most rapid from the 9–10th month of gestation with an average increase of 240 g per week50 and head circumference below the 10th percentile during the 7.5–9th month of gestation is associated with an increased risk of low birth weight 51. Therefore, we considered that cotinine measurement of the 8th month of gestation, before the period of most rapid infant growth, provides high validity.…”

Fetal growth standards in gastroschisis: Reference values for ultrasound measurements

“…Growth pattern of 70 fetuses with gastroschisis were studied, comparing the measurements of their biometric parameters with those of nonaffected fetuses, one may demonstrate that their growth rate is reduced in a symmetrical fashion from the second trimester, with 41% of fetuses with gastroschisis being SGA at birth . In another study, 13 of the 25 fetuses with gastroschisis analyzed (52%) were SGA at birth .…”