Symphysis‐fundal height growth chart of an obstetric cohort of 817 Mozambican women with ultrasound‐dated singleton pregnancies

Abstract

SummaryOur aim was to construct a new symphysis-fundus height (SFH) growth chart, based on Mozambican women with ultrasound-dated singleton pregnancy, who represent the largest obstetric cohort in a developing country followed for this purpose. Two antenatal clinics were chosen in the suburban area of Maputo City. A cohort of 904 consecutively recruited antenatal clients was followed until delivery. The growth of the SFH was measured every second to third week. Gestational age was determined by ultrasound at enrolment. Women with multiple pregnancy or with gestational age > 21 weeks at enrolment were excluded. The average number of antenatal SFH measurements per woman was 7.8 (SD 2.4). The drop out rate was 9.6%. Mean birthweight was 2909 g. Pre-term deliveries occurred in 15% and low birthweight deliveries (< 2500 g) in 16%. Using proper longitudinal methods, we constructed an FH growth chart and compared it with various previously published SFH charts, which showed the Mozambican chart to be 0-3 cm below the others. Nulliparous women were 0.5 cm below multiparous women. We did not find any difference in the SFH growth charts between women with or without overt morbidity. Women with a body mass index (BMI) < 19 and women with a BMI > 27 had approximately 1 cm lower and 1 cm higher readings, respectively, than women with normal BMI. The Mozambican SFH growth chart is an example of an elaborated growth chart for a well-defined population in a low-income country. It constitutes the basis for further studies to predict the small-for-gestational age newborn from anthropometrical data obtained by use of appropriate technology.keywords symphysis-fundus height, BMI, overt morbidity, pre-term delivery, foetal growth, Mozambique.correspondence

La mesure de la hauteur utérine dans les grossesses uniques et le dépistage des retards de croissance intra-utérins

“…Pour Challis et al [16,17], et Steingrimsdottir et al [14], les courbes des maigres (<10 e c) et celles des obèses (> 90 e c) sont différentes de 2 cm. Les courbes personnalisées de Gardosi et Francis [18,19] tiennent compte du poids maternel.…”

“…Les courbes suédoises [2,14,22,23], galloises [11], argentines [9], éthiopiennes [24], du Botswana [15] et du Mozambique [16] sont très proches et sont les courbes moyennes. Les courbes les plus basses sont celles établies en Tanzanie [25], aux Indes [26], et au Togo [27].…”

“…Influence de la parité, de la connaissance du terme et de la hauteur de la présentation L'influence de ces facteurs de variation est faible [9,14,16,17,28,29].…”

International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21stProject: prospective cohort study in eight countries

“…In fact, we believe that at least 21 different, locally derived SFH charts are currently being used in clinical practice worldwide 89 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29…”

Effects of body mass index in pregnant women on fundal height charts

“…В исследовании проведенном на когорте беременных Мозамбика, Challis K. и соавторы установили, что высота стояния дна матки у женщин с ИМТ < 19 на 1 см ниже, чем у женщин с нормальным ИМТ. Высота стояния дна матки у беременных с ИМТ > 27 была приблизительно на 1 см выше чем в группе с нормальным ИМТ соответственно [9]. Беременные с исходно низким весом и малой прибавкой веса во время беременности имеют большие риски для рождения детей с весом ниже 5 ‰ [10].…”