RETIRED: Determination of Gestational Age by Ultrasound

Butt, Kimberly; Lim, Kenneth; Bly, Sara; Cargill, Yvonne; Davies, Greg; Denis, Nathalie; Hazlitt, Gail; Morin, Lucie; Ouellet, Annie; Salem, Shia

doi:10.1016/s1701-2163(15)30664-2

Cited by 210 publications

(143 citation statements)

References 100 publications

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“…In the 35% of infants dated from 14 to 24 weeks only head measurements were used to estimate GA in alignment with recommendations at the time of introduction of ultrasound to the setting. However, a combination of multiple biometric parameters (biparietal diameter, head circumference, abdominal circumference, and/or femur length) may be recommended to determine GA, rather than a single parameter [11],[21].…”

Section: Discussionmentioning

confidence: 99%

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Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

et al. 2014

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BackgroundThe association between malaria during pregnancy and low birth weight (LBW) is well described. This manuscript aims to quantify the relative contribution of malaria to small-for-gestational-age (SGA) infants and preterm birth (PTB) in pregnancies accurately dated by ultrasound on the Thai-Myanmar border at the Shoklo Malaria Research Unit.Methods and FindingsFrom 2001 to 2010 in a population cohort of prospectively followed pregnancies, we analyzed all singleton newborns who were live born, normal, weighed in the first hour of life and with a gestational age (GA) between 28+0 and 41+6 weeks. Fractional polynomial regression was used to determine the mean birthweight and standard deviation as functions of GA. Risk differences and factors of LBW and SGA were studied across the range of GA for malaria and non-malaria pregnancies. From 10,264 newborns records, population centiles were created.Women were screened for malaria by microscopy a median of 22 [range 1–38] times and it was detected and treated in 12.6% (1,292) of pregnancies. Malaria was associated with LBW, PTB, and SGA compared to those without malaria. Nearly two-thirds of PTB were classified as LBW (68% (539/789)), most of which 83% (447/539) were not SGA. After GA 39 weeks, 5% (298/5,966) of non-LBW births were identified as SGA. Low body mass index, primigravida, hypertension, smoking and female sex of the newborn were also significantly and independently associated with LBW and SGA consistent with previous publications.ConclusionsTreated malaria in pregnancy was associated with an increased risk for LBW, PTB, and SGA, of which the latter are most important for infant survival. Using LBW as an endpoint without adjusting for GA incorrectly estimated the effects of malaria in pregnancy. Ultrasound should be used for dating pregnancies and birth weights should be expressed as a function (or adjusted for GA) of GA in future malaria in pregnancy studies.

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Section: Discussionmentioning

confidence: 99%

“…The training manual and protocol for obtaining trans-abdominal CRL and biometry measurements was based on recommendations from the British Medical Ultrasound Society [20]. Measurements after 24 weeks GA are unreliable for accurate pregnancy dating [21], [22].…”

Section: Methodsmentioning

confidence: 99%

Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

et al. 2014

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“…The TVC189-TVC190 mother-child pair was noninformative because only 1 time point was available for analysis for the child. In the case of TVC79-TVC80 (woman infected with HCV alone), the median timing estimate of vertical transmission was 31.1 weeks of gestation (95% high posterior density [HPD] of estimated origin values ϭ 25.3 to 39.1 weeks of gestation), hence mostly within the boundaries of the 3rd trimester (i.e., Ն28 weeks [27]) (Fig. 4).…”

Section: Resultsmentioning

confidence: 99%

“…None were produced for TVC31-TVC32, as the last maternal serum sample obtained from the mother was 3.4 years before delivery of the child as a result of loss to follow-up. Assessment of infectivity revealed that while most aHCVpp were clearly infectious, some were mark- , and 3rd trimesters of pregnancy were defined as 1 to 13, 14 to 27, and Ն28 weeks of gestation (27).…”

Section: Resultsmentioning

confidence: 99%

“…These participants were enrolled in the Centre maternel et infantile sur le SIDA (CMIS) Mother-Child Cohort (CHU Sainte-Justine, Montreal, Canada). First, 2nd, and 3rd trimesters of pregnancy were defined as 1 to 13, 14 to 27, and Ն28 weeks of gestation, and gestational age was estimated based on 1st trimester ultrasound or best available data (27). HCV infection in the child was diagnosed following detection of HCV RNA in plasma at birth (COBAS Amplicor HCV test version 2.0; Roche Diagnostics).…”

Section: Methodsmentioning

confidence: 99%

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Vertical Transmission of Hepatitis C Virus: Variable Transmission Bottleneck and Evidence of Midgestation In Utero Infection

Fauteux‐Daniel

Larouche

Calderon

et al. 2017

J Virol

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Hepatitis C virus (HCV) can be transmitted from mother to child during pregnancy and childbirth. However, the timing and precise biological mechanisms that are involved in this process are incompletely understood, as are the determinants that influence transmission of particular HCV variants. Here we report results of a longitudinal assessment of HCV quasispecies diversity and composition in 5 cases of vertical HCV transmission, including 3 women coinfected with human immunodeficiency virus type 1 (HIV-1). The population structure of HCV variant spectra based on E2 envelope gene sequences (nucleotide positions 1491 to 1787), including hypervariable regions 1 and 2, was characterized using next-generation sequencing and median-joining network analysis. Compatible with a loose transmission bottleneck, larger numbers of shared HCV variants were observed in the presence of maternal coinfection. Coalescent Bayesian Markov chain Monte Carlo simulations revealed median times of transmission between 24.9 weeks and 36.1 weeks of gestation, with some confidence intervals ranging into the 1st trimester, considerably earlier than previously thought. Using recombinant autologous HCV pseudoparticles, differences were uncovered in HCV-specific antibody responses between coinfected mothers and mothers infected with HCV alone, in whom generalized absence of neutralization was observed. Finally, shifts in HCV quasispecies composition were seen in children around 1 year of age, compatible with the disappearance of passively transferred maternal immunoglobulins and/or the development of HCVspecific humoral immunity. Taken together, these results provide insights into the timing, dynamics, and biologic mechanisms involved in vertical HCV transmission and inform preventative strategies.IMPORTANCE Although it is well established that hepatitis C virus (HCV) can be transmitted from mother to child, the manner and the moment at which transmission operates have been the subject of conjecture. By carrying out a detailed examination of viral sequences, we showed that transmission could take place comparatively early in pregnancy. In addition, we showed that when the mother also carried human immunodeficiency virus type 1 (HIV-1), many more HCV variants were shared between her and her child, suggesting that the mechanism and/or the route of transmission of HCV differed in the presence of coinfection with HIV-1. These results

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Association Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes

Ray

Vermeulen

Bharatha

et al. 2016

JAMA

619

336

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IMPORTANCE Fetal safety of magnetic resonance imaging (MRI) during the first trimester of pregnancy or with gadolinium enhancement at any time of pregnancy is unknown. OBJECTIVE To evaluate the long-term safety after exposure to MRI in the first trimester of pregnancy or to gadolinium at any time during pregnancy. DESIGN, SETTING, AND PARTICIPANTS Universal health care databases in the province of Ontario, Canada, were used to identify all births of more than 20 weeks, from 2003-2015. EXPOSURES Magnetic resonance imaging exposure in the first trimester of pregnancy, or gadolinium MRI exposure at any time in pregnancy. MAIN OUTCOMES AND MEASURES For first-trimester MRI exposure, the risk of stillbirth or neonatal death within 28 days of birth and any congenital anomaly, neoplasm, and hearing or vision loss was evaluated from birth to age 4 years. For gadolinium-enhanced MRI in pregnancy, connective tissue or skin disease resembling nephrogenic systemic fibrosis (NSF-like) and a broader set of rheumatological, inflammatory, or infiltrative skin conditions from birth were identified. RESULTS Of 1 424 105 deliveries (48% girls; mean gestational age, 39 weeks), the overall rate of MRI was 3.97 per 1000 pregnancies. Comparing first-trimester MRI (n = 1737) to no MRI (n = 1 418 451), there were 19 stillbirths or deaths vs 9844 in the unexposed cohort (adjusted relative risk [RR], 1.68; 95% CI, 0.97 to 2.90) for an adjusted risk difference of 4.7 per 1000 person-years (95% CI, −1.6 to 11.0). The risk was also not significantly higher for congenital anomalies, neoplasm, or vision or hearing loss. Comparing gadolinium MRI (n = 397) with no MRI (n = 1 418 451), the hazard ratio for NSF-like outcomes was not statistically significant. The broader outcome of any rheumatological, inflammatory, or infiltrative skin condition occurred in 123 vs 384 180 births (adjusted HR, 1.36; 95% CI, 1.09 to 1.69) for an adjusted risk difference of 45.3 per 1000 person-years (95% CI, 11.3 to 86.8). Stillbirths and neonatal deaths occurred among 7 MRI-exposed vs 9844 unexposed pregnancies (adjusted RR, 3.70; 95% CI, 1.55 to 8.85) for an adjusted risk difference of 47.5 per 1000 pregnancies (95% CI, 9.7 to 138.2). CONCLUSIONS AND RELEVANCE Exposure to MRI during the first trimester of pregnancy compared with nonexposure was not associated with increased risk of harm to the fetus or in early childhood. Gadolinium MRI at any time during pregnancy was associated with an increased risk of a broad set of rheumatological, inflammatory, or infiltrative skin conditions and for stillbirth or neonatal death. The study may not have been able to detect rare adverse outcomes.

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RETIRED: Determination of Gestational Age by Ultrasound

Cited by 210 publications

References 100 publications

Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

Vertical Transmission of Hepatitis C Virus: Variable Transmission Bottleneck and Evidence of Midgestation In Utero Infection

Association Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes

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