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Updated: Jul 7, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Fetal Growth and Adiposity of Infants Born Large for Gestational Age in Three Harmonized Randomized Trials
Amanda J Poprzeczny1,2, Jennie Louise1,3, Andrea R Deussen1
1The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia.
Insights
Infants born large for gestational age (LGA) show larger fetal growth and adiposity from 20 weeks gestation. Interventions to prevent LGA births should begin earlier in pregnancy or before conception.
Area of Science:
- Perinatal Medicine
- Maternal-Fetal Medicine
- Neonatology
Background:
- Infants born large for gestational age (LGA) face increased risks for adverse health outcomes.
- Understanding fetal growth trajectories is crucial for developing effective interventions to prevent LGA births.
Purpose of the Study:
- To compare fetal growth and adiposity in LGA infants versus non-LGA infants.
- To determine if LGA is due to consistent larger size or altered growth trajectories throughout gestation.
Main Methods:
- Secondary analysis of data from three randomized trials (LIMIT, GRoW, Optimise).
- Included women with singleton gestations and a wide range of maternal BMI.
- Utilized ultrasound data at 28 and 36 weeks' gestation to measure fetal biometry and adiposity.
Main Results:
- LGA infants exhibited larger fetal biometry measures from 20 weeks' gestation.
- Fetal adiposity measures were consistently higher in LGA infants, with increasing differences over gestation.
- Maternal BMI did not appear to influence the differences in biometry and adiposity.
Conclusions:
- Larger fetal biometry in LGA infants is evident from early gestation (20 weeks).
- Interventions aimed at preventing LGA births may need to be implemented earlier in pregnancy or even preconceptionally.
Objective:
Infants born large for gestational age (LGA) are at an increased risk of short- and longer-term adverse outcomes. Understanding fetal growth and adiposity and their trajectories may help inform interventions to prevent birth of LGA infants. We aimed to compare fetal growth and adiposity measures of infants born LGA with those born not LGA, to determine whether the discrepancy at birth was primarily due to larger size throughout gestation, or instead to different trajectories of fetal growth.
Study Design:
This was a secondary analysis of secondary outcomes of fetal growth and adiposity from three harmonized randomized trials-the LIMIT, GRoW, and Optimise randomized trials. These trials recruited women in early pregnancy, and a singleton gestation, from three major public metropolitan Adelaide maternity hospitals. Maternal body mass index (BMI) ranged from 18.5 to ≥40.0 kg/m2. Data were obtained from enrolled women who underwent research ultrasounds at 28 and 36 weeks' gestation. Outcome measures were ultrasound measures of fetal biometry and adiposity.
Results:
Infants born LGA had larger fetal biometry measures, and higher growth trajectories, from 20 weeks' gestation. Fetal adiposity measures were consistently larger among infants born LGA and these differences increased over time. We did not find evidence that the differences in biometry and adiposity measurements varied according to maternal BMI.
Conclusion:
Infants born LGA had larger fetal biometry measures at all time points from 20 weeks' gestation, compared with infants born not LGA suggesting any interventions to prevent LGA likely need to commence earlier in pregnancy or prior to conception.
Key Points:
· Infants born LGA had larger fetal biometry measures from 20 weeks' gestation.. · Infants born LGA had larger fetal adiposity measures.. · Interventions to prevent LGA need to start earlier in pregnancy or prior to conception..
