Razão peso/perímetro cefálico ao nascer na avaliação do crescimento fetal

Gonçalves, Fabiana Cristina Lima da Silva Pastich; Lira, Pedro Israel Cabral de; Eickmann, Sophie Helena; Lima, Marília de Carvalho

doi:10.1590/0102-311x00184014

Cited by 10 publications

(7 citation statements)

References 24 publications

(30 reference statements)

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“…Placental insufficiency leads to asymmetric FGR due to redistribution of fetal blood flow and fetal brainsparing, which can eventually lead to stillbirths, the catastrophic end result of severe placental insufficiency [ 1 ]. A lower W/HC ratio has previously been shown to indicate asymmetrical FGR, and in our study newborns in the abnormal RI group had significantly lower W/HC ratios compared to newborns in the normal RI group [ 20 , 21 ]. In terms of postnatal growth, Z-scores for weight, length, and HC in SGA babies in our cohort were significantly lower than the AGA group up to 10 weeks, but not thereafter.…”

Section: Discussionsupporting

confidence: 67%

The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

et al. 2021

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Background Fetal growth restriction (FGR), defined as a fetus failing to reach its genetic growth potential, remains poorly diagnosed antenatally. This study aimed to assess the ability of continuous-wave Doppler ultrasound of the umbilical artery (CWD-UmA) to detect FGR in healthy women with low-risk pregnancies. Methods and findings This prospective longitudinal descriptive cohort study enrolled infants born to low-risk mothers who were screened with CWD-UmA between 28–34 weeks’ gestation; the resistance index (RI) was classified as normal or abnormal. Infants were assessed at 6, 10, 14 weeks, and 6 months postnatally for anthropometric indicators and body composition using the deuterium dilution method to assess fat-free mass (FFM). Neonates in the abnormal RI group were compared with those in the normal RI group, and neonates classified as small-for-gestational age (SGA) were compared with appropriate-for-gestational age (AGA) neonates. Eighty-one term infants were included. Only 6 of 26 infants (23.1%) with an abnormal RI value would have been classified as SGA. The abnormal RI group had significantly reduced mean FFM and FFM-for-age Z-scores at 6, 10, 14 weeks, and 6 months compared with the normal RI group (P<0.015). The SGA group’s FFM did not show this consistent trend when compared to AGA FFM, being significantly different only at 6 months (P = 0.039). The main limitation of the study was the small sample size of the infant follow-up. Conclusions Abnormal RI obtained from CWD-UmA is able to detect FGR and is considered a useful addition to classifying the neonate only by SGA or AGA at birth.

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Section: Discussionsupporting

confidence: 67%

The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

et al. 2021

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“…Reconhecidamente, mulheres com alturas mais baixas tendem a gerar conceptos com comprimento igualmente baixo e provável crescimento limitado frente aos filhos de mulheres com altura normal ou alta 15,24,27 . Esta relação pode estar associada a restrições no desenvolvimento e crescimento no útero materno, além de também perpetuar o ciclo da desnutrição crônica devido à manutenção da baixa estatura através das gerações subsequentes 28 Apesar da altura materna também ser conhecida por sua relação de causa -efeito com o baixo peso ao nascer, neste estudo não foi encontrado associação do peso ao nascimento com restrições no crescimento linear das crianças 22,29,30 .…”

Section: Discussionunclassified

Desnutrição e fatores associados em crianças quilombolas menores de 60 meses em dois municípios do estado do Maranhão, Brasil

Silveira

Padilha²,

Frota

2020

Ciênc. saúde coletiva

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Resumo O objetivo deste artigo é avaliar a prevalência de desnutrição em crianças menores de 60 meses residentes em comunidades remanescentes de quilombos de dois municípios do estado do Maranhão e seus fatores associados. Estudo transversal com amostra de 372 crianças realizado em agosto de 2015. Foram coletadas informações socioeconômicas, demográficas, maternas e das crianças. A antropometria seguiu o proposto pela Organização Mundial da Saúde. Foram calculados os índices estatura para idade e peso para estatura utilizando o software Anthro versão 3.2.2. Foi realizada regressão de Poisson com variância robusta para a associação da desnutrição com as variáveis estudadas, utilizando o software Stata versão 14.0. A desnutrição em crianças foi elevada segundo a estatura-por-idade (15,1%) e peso-para-estatura (7%). Crianças cujas mães possuíam baixa estatura (< 1,497 m) apresentaram mais chances de possuírem déficit de estatura-para-idade (p < 0,05). Nenhuma variável se associou estatisticamente ao baixo peso-para-estatura. A desnutrição infantil persiste como problema de saúde pública em regiões vulneráveis e os fatores maternos como a baixa estatura materna podem explicar a baixa estatura dos filhos. Aponta-se para a necessidade de ações de enfrentamento deste desvio nutricional.

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“…Growth charts remain the cornerstone of interpreting growth indices in childhood (62) . WHO Multicentre Growth Reference Study (MGRS) Growth Standards are intended as a single, global growth standard by which children of all (61) References/standards: none, but lower BW:PW suggests impaired nutrient transfer across placenta (61) Cut-offs: no universal cut-offnormal BW:PW at term = 5-7 (61) Body size and proportions Birth anthropometry: -Weight -Length -Head circumference Gestational age-related -Weight-for-GA -Length-for-GA -HC-for-GA (Sex-specific) References/standards: -INTERGROWTH-21st (52,102) -Fenton 2013 (includes Olsen data) (53) Cut-offs: Weight-for-GA (1) : -< 10th percentile = SGA −10th-90th percentile = AGA -> 90th percentile = LGA Proportionality -BW/HC ratio -Difference between BW and HC z-score -W/L ratio (GA-and sex-specific) -Ponderal index (GA-specific) -BMI (BMI; GA-and sex-specific) References/standards: -INTERGROWTH-21st: W/L ratio-for-GA (103) -Olsen 2015: BMI-for-GA (57) -Landmann 2006: ponderal index-for-GA (56) Cut-offs: -BW/HC ratio < 90 (proposed, unvalidated) (58) -HCZ-BWZ > 1 (proposed, unvalidated) (59) -PI < 2 or < 10th percentile for GA (13,55) Body composition Body volume (by air-displacement plethysmography)…”

Section: Antenatal Period: Foetal Growth Assessmentmentioning

confidence: 99%

Integrated growth assessment in the first 1000 d of life: an interdisciplinary conceptual framework

Nel

Pattinson

Vannevel

et al. 2023

Public Health Nutr.

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Objectives: Prenatal growth affects short- and long-term morbidity, mortality and growth, yet communication between prenatal and postnatal healthcare teams is often minimal. This paper aims to develop an integrated, interdisciplinary framework for foetal/ infant growth assessment, contributing to continuity of care across the first 1000 days of life. Design: A multidisciplinary think-tank met regularly over many months to share and debate their practice and research experience related to foetal/ infant growth assessment. Participants’ personal practice and knowledge was verified against and supplemented by published research. Setting: Online and in-person brainstorming sessions of growth assessment practices that are feasible and valuable in resource-limited, low- and middle-income country (LMIC) settings. Participants: A group of obstetricians, paediatricians, dietitians/ nutritionists, and a statistician. Results: Numerous measurements, indices and indicators were identified for growth assessment in the first 1000 days. Relationships between foetal, neonatal and infant measurements were elucidated and integrated in an interdisciplinary framework. Practices relevant to LMICs were then highlighted: antenatal Doppler screening, comprehensive and accurate birth anthropometry (including proportionality of weight, length and head circumference), placenta weighing, and incorporation of length-for-age, weight-for-length and mid-upper arm circumference in routine growth monitoring. The need for appropriate, standardised clinical records and corresponding policies to guide clinical practice and facilitate interdisciplinary communication over time became apparent. Conclusions: Clearer communication between prenatal, perinatal and postnatal health care providers, within the framework of a common understanding of growth assessment and a supportive policy environment, is a prerequisite to continuity of care and optimal health and development outcomes.

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Razão peso/perímetro cefálico ao nascer na avaliação do crescimento fetal

Cited by 10 publications

References 24 publications

The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

Desnutrição e fatores associados em crianças quilombolas menores de 60 meses em dois municípios do estado do Maranhão, Brasil

Integrated growth assessment in the first 1000 d of life: an interdisciplinary conceptual framework

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