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Is severe macrosomia manifested at 11-14 weeks of gestation?
R Hackmon1, K B Le Scale, J Horani
1Lenox Hill Hospital, Department of Obstetrics and Gynecology, New York, NY, USA. rhackmon@fhcrc.org
Summary
Severe fetal overgrowth, or macrosomia, can be detected as early as 11-14 weeks' gestation. Discrepancies in fetal size during nuchal translucency screening are associated with increased risk of macrosomia at birth.
Area of Science:
- Maternal-fetal medicine
- Prenatal diagnostics
- Neonatal outcomes
Background:
- Severe macrosomia poses risks to both mother and infant.
- Early detection of macrosomia is crucial for appropriate management.
- Fetal biometry in early pregnancy may offer predictive value.
Purpose of the Study:
- To investigate the association between first-trimester fetal biometry and severe macrosomia.
- To determine if fetal size discrepancies in early pregnancy predict later macrosomia.
Main Methods:
- Case-control study comparing 30 severely macrosomic neonates with 90 appropriate-for-gestational age controls.
- Nuchal translucency (NT) screening performed at 11-14 weeks' gestation.
- Analysis of the difference between measured and expected crown-rump length (CRL) in relation to birth weight.
Main Results:
- A statistically significant greater difference between measured and expected CRL (in mm and days) was observed in the macrosomic group compared to controls (P < 0.0001).
- Significant correlations were found between the degree of macrosomia and the fetal size discrepancy at NT screening (r = 0.47-0.48, P < 0.01).
Conclusions:
- Severe macrosomia appears to have early fetal growth manifestations detectable by 11-14 weeks' gestation.
- Early fetal biometry, specifically CRL measurement during NT screening, can indicate a risk for subsequent severe macrosomia.
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