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Published on: June 29, 2013
Assessment of fetal growth by customized growth charts
Romy Gaillard1, Vincent W V Jaddoe
1The Generation R Study Group and Departments of Epidemiology and Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
Insights
Customized fetal growth charts offer improved distinction between growth-restricted and normally growing fetuses. Further validation is needed to confirm their clinical utility in identifying at-risk infants.
Area of Science:
- Perinatal medicine
- Fetal development
- Biostatistics
Background:
- Standard fetal growth charts do not account for individual growth potential.
- Pathological fetal growth restriction (FGR) diagnosis can be improved with individualized standards.
- Current customized models use maternal and fetal characteristics.
Purpose of the Study:
- To evaluate the utility of customized fetal weight charts.
- To differentiate between pathological FGR and constitutionally small fetuses.
- To assess the predictive power of maternal and fetal characteristics for fetal growth.
Main Methods:
- Development of customized fetal growth standards based on birth weight and fetal growth data.
- Inclusion of variables such as gestational age, maternal age, parity, ethnicity, height, weight, and fetal sex.
- Analysis of the physiological basis and predictive strength of these customization variables.
Main Results:
- Customized charts may enhance the distinction between growth-restricted and constitutionally small fetuses.
- The predictive strength of current customization variables for individual fetal growth remains debated.
- Existing customized charts show potential for epidemiological and clinical applications.
Conclusions:
- Customized fetal growth charts show promise for improving fetal assessment.
- Further research is essential to validate these models and their impact on identifying at-risk infants.
- The role of specific maternal and fetal characteristics in predicting individual fetal growth requires continued investigation.
Abstract:
Customized fetal growth charts take account of the individual variation in the fetal growth potential based on non-pathological maternal and fetal characteristics. Application of these customized weight charts might improve the distinction between pathological growth-restricted fetuses and fetuses that are small but have reached their growth potential. Current models for customized growth standards have been based on birth weight and fetal growth data. Variables used for customization are gestational age, maternal age, parity, ethnicity, height, weight and fetal sex. Thus far, it remains controversial whether these maternal and fetal characteristics used for customization are strong enough predictors for fetal growth on an individual level and are truly physiological characteristics. The currently available customized growth charts might be of benefit for use in epidemiological studies and clinical practice. Further studies are needed to validate these customized growth models and to examine whether and to what extend they improve identification of children that are at risk for morbidity in the perinatal period and later in life.
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