Patterns of Fetal Growth in a Rural Indian Cohort and Comparison With a Western European Population

Kinare, Arun S.; Chinchwadkar, Manoj C.; Natekar, Asit S.; Coyaji, Kurus; Wills, Andrew K.; Joglekar, Charudatta; Yajnik, Chittaranjan S.; Fall, Caroline

doi:10.7863/jum.2010.29.2.215

Cited by 33 publications

(43 citation statements)

References 19 publications

(25 reference statements)

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“…The inter-observer variation in the extracted fetal measurements was excellent (0.004–0.04%). Full technical details on the fetal measurements [20] and the placental measurements [21] have been reported elsewhere.…”

Section: Methodsmentioning

confidence: 99%

“…Serial fetal ultrasound alongside data from birth should provide a better marker of growth restriction. Fetal growth is characterised by substantial centile crossing in individual growth trajectories suggesting it is a highly adaptive process [13]. Studies to date have tended to examine cross sectional associations at each time of measurement [14] or modeled the trajectory using multilevel methods [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Maternal and paternal height and BMI and patterns of fetal growth: The Pune Maternal Nutrition Study

Wills

Chinchwadkar²,

Joglekar³

et al. 2010

Early Human Development

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We examined the differential associations of each parent's height and BMI with fetal growth, and examined the pattern of the associations through gestation. Data are from 557 term pregnancies in the Pune Maternal Nutrition Study. Size and conditional growth outcomes from 17 to 29 weeks to birth were derived from ultrasound and birth measures of head circumference, abdominal circumference, femur length and placental volume (at 17 weeks only). Parental height was positively associated with fetal head circumference and femur length. The associations with paternal height were detectible earlier in gestation (17–29 weeks) compared to the associations with maternal height. Fetuses of mothers with a higher BMI had a smaller mean head circumference at 17 weeks, but caught up to have larger head circumference at birth. Maternal but not paternal BMI, and paternal but not maternal height, were positively associated with placental volume. The opposing associations of placenta and fetal head growth with maternal BMI at 17 weeks could indicate prioritisation of early placental development, possibly as a strategy to facilitate growth in late gestation. This study has highlighted how the pattern of parental–fetal associations varies over gestation. Further follow-up will determine whether and how these variations in fetal/placental development relate to health in later life.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal and paternal height and BMI and patterns of fetal growth: The Pune Maternal Nutrition Study

Wills

Chinchwadkar²,

Joglekar³

et al. 2010

Early Human Development

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“…Kinare et al observed that fetal size was smaller in a rural Indian population than in European or urban Indian populations with significant differences in fetal biometric measurements. [16]. As observed by Spencer et al, the smallness of Indian fetuses appeared to be related mainly to a smaller abdominal circumference, showing a normal growth pattern significantly below the median for the European growth charts.…”

Section: Discussionmentioning

confidence: 70%

The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

Maso

Jayawardane

Alberico

et al. 2014

The Scientific World Journal

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The antenatal condition of small for gestational age (SGA) is significantly associated with perinatal morbidity and mortality and it is known that there are significant differences in birth weight and fetal size among different populations. The aim of our study was to assess the impact on outcomes of the diagnosis of SGA according to Bangladeshi and European antenatal growth charts in Sri Lankan population. The estimated fetal weight before delivery was retrospectively reviewed according to Bangladeshi and European growth references. Three groups were identified: Group 1-SGA according to Bangladeshi growth chart; Group 2-SGA according to European growth chart but not having SGA according to Bangladeshi growth chart; Group 3-No SGA according to both charts. There was a difference in prevalence of SGA between Bangladeshi and European growth charts: 12.7% and 51.7%, respectively. There were statistically significant higher rates in emergency cesarean section, fetal distress in labour, and intrauterine death (P < 0.001) in Group 1 compared with Group, 2 and 3. No differences of outcomes occurred between Groups 2 and 3. Our study demonstrated that only cases diagnosed as SGA according to population-based growth charts are at risk of adverse outcome. The use of inappropriate prenatal growth charts might lead to misdiagnosis and potential unnecessary interventions.

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“…Present findings are similar to those of Helcowitz et al 5 However, Kinare AS et al in their study found fetal size to be smaller in rural Indian population than in urban Indian population. 6 In present study, we tried to evaluate growth of fetus using serial SFH measurements Rate of growth of SFH >2 cm per week was considered normal. The sensitivity of diagnosis of IUGR using SFH measurement in our study was found to be 71%, specificity 43%, NPV 33%, PPV of 79% (Table 3, 7).…”

Section: Discussionmentioning

confidence: 99%

Validity of clinical and sonographic diagnosis of IUGR: a comparative study

Marhatta

Kaul

2017

Int J Reprod Contracept Obstet Gynecol

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Background: IUGR refers to a condition in which a fetus is unable to grow to its genetically predetermined potential size. It is the major cause of perinatal morbidity and mortality in developing countries. The present study was conducted to compare the validity of clinical diagnosis against sonographic diagnosis of IUGR. Methods: This study was conducted in the department of Obstetrics and Gynaecology, SMGS Hospital, Jammu from Octobar 2013 to September 2014. It included 247 women with singleton pregnancies with longitudinal lie. They underwent serial clinical assessment using SFH, AG and weight gain along with Ultrasound and Doppler of Umbilical & Middle cerebral artery. Birth weight of newborns was measured at delivery and was thereafter correlated with clinical and sonographic diagnosis; to access their validity. Results: Sensitivity of SFH in detecting IUGR was 71.4% against 75.7% by Ultrasound and was highest with Doppler of 82.9%. Specificity was 43.6% by SFH, 64.3% by Ultrasound and 86.2% by Doppler. Doppler also had the highest NPV of 92.6% against 79.1% by SFH and 86.8% by Ultrasound. The combination of clinical and ultrasound diagnosis increased the sensitivity to 95.2% and NPV to 95.91%. However, the combination of clinical and Doppler assessments did not significantly change the outcome. Conclusions: Doppler is the single best investigation available for diagnosing IUGR with a high specificity and NPV. However, importance of clinical diagnosis cannot be overlooked, especially in a developing country with limited resources like ours. In the absence of Doppler combined clinical and Ultrasound assessment should be considered.

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Patterns of Fetal Growth in a Rural Indian Cohort and Comparison With a Western European Population

Abstract: Fetal size was smaller in a rural Indian population than in European and urban Indian populations, even in mid pregnancy. The deficit varied for different fetal measurements; it was greatest for AC and BPD and least for FL and HC.

Cited by 33 publications

References 19 publications

Maternal and paternal height and BMI and patterns of fetal growth: The Pune Maternal Nutrition Study

Maternal and paternal height and BMI and patterns of fetal growth: The Pune Maternal Nutrition Study

The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

Validity of clinical and sonographic diagnosis of IUGR: a comparative study

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