Deceleration of fetal growth rate as alternative predictor for childhood outcomes: a birth cohort study.

Autor: Broere-Brown ZA; Department of Obstetrics and Gynecology, Erasmus MC - University Medical Center, room Na 2918, PO Box 2040, 3000 CA, Rotterdam, The Netherlands., Schalekamp-Timmermans S; Department of Obstetrics and Gynecology, Erasmus MC - University Medical Center, room Na 2918, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. s.timmermans@erasmusmc.nl., Jaddoe VWV; Department of Epidemiology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Erasmus MC - University Medical Center, Rotterdam, The Netherlands., Steegers EAP; Department of Obstetrics and Gynecology, Erasmus MC - University Medical Center, room Na 2918, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2019 Jun 27; Vol. 19 (1), pp. 216. Date of Electronic Publication: 2019 Jun 27.
DOI: 10.1186/s12884-019-2358-8
Abstrakt: Background: Small for gestational age (SGA) is frequently used to define fetal growth restriction (FGR). However, FGR describes a slowdown in fetal growth and is not synonymous with SGA, which may introduce misclassification. We investigated the effect of both on delivery and childhood outcomes.
Methods: From a prospective population-based cohort study we included 7959 live singleton births with data available on second trimester estimated fetal weight (EFW) and birth weight. We used a decrease in growth of > 40 percentiles between second trimester EFW and birthweight to define a deceleration in growth. SGA was defined as birthweight Results: Deceleration of growth occurred in 27,2% in SGA neonates and in 10,3% of neonates with an appropriate for gestational age (AGA) birthweight. Of all fetuses with decelerated growth, 90% was born AGA. SGA neonates were more often delivered by instrumental delivery or cesarean section and admitted to NICU. Both decelerated growth and SGA were associated with accelerated growth at 2 years, a smaller aortic diameter and lower left ventricular mass at 6 years.
Conclusions: Both decelerated growth and SGA are associated with unfavorable clinical outcomes in childhood. In addition to SGA, neonates with deceleration of growth should be considered a high-risk group.
Databáze: MEDLINE
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