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Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth
Author(s) -
Lampl Michelle,
Kusanovic Juan Pedro,
Erez Offer,
Gotsch Francesca,
Espinoza Jimmy,
Goncalves Luis,
Lee Wesley,
Gomez Ricardo,
Nien Jyh Kae,
Frongillo Edward A.,
Romero Roberto
Publication year - 2009
Publication title -
american journal of human biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.559
H-Index - 81
eISSN - 1520-6300
pISSN - 1042-0533
DOI - 10.1002/ajhb.20880
Subject(s) - biparietal diameter , medicine , fetus , gestational age , gestation , obstetrics , fetal growth , pregnancy , head circumference , birth weight , biology , genetics
The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies ( n = 3,706) and those with an episode of preterm labor followed by term delivery ( n = 184) were identical across the time intervals 16–22 weeks, 22–28 weeks, and 28–34 weeks in a multilevel mixed‐effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor ( P < 0.05), declined across midgestation (22–28 weeks, P < 0.05), and rebounded between 28 and 34 weeks ( P = 0.06). This was associated with perturbations in abdominal circumference growth and proportionately larger biparietal diameter from 22 gestational weeks ( P = 0.03), greater femur ( P = 0.01), biparietal diameter ( P = 0.001) and head circumference ( P = 0.02) dimensions relative to abdominal circumference across midgestation (22–28 weeks), followed by proportionately smaller femur diaphyseal length ( P = 0.02) and biparietal diameter ( P = 0.03) subsequently. A distinctive rapid growth phenotype characterized fetal growth preceding an episode of preterm labor among this sample of term‐delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre‐dating the preterm labor episode. Am. J. Hum. Biol., 2009. © 2009 Wiley‐Liss, Inc.