Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study
Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study
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DOI：
10.1136/bmj.39129.637917.ae
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发表时间：
2007-04-21
影响因子：
105.7
通讯作者：
D'Alton, M. E.
中科院分区：
文献类型：
--
作者：
Bukowski, R.;Smith, G. C. S.;D'Alton, M. E.
目的探讨妊娠早期胎儿生长与出生体重、妊娠时间、研究设计：对1999年至2003年间38033例妊娠妇女进行前瞻性队列研究，研究对象为来自美国主要地区的15个中心的976名因辅助生殖而受孕的妇女该研究所的一名妇女在怀孕前三个月用超声波测量胎儿的顶臀长度，并产下了一个活的单胞胎婴儿，没有染色体或先天性异常的证据。孕早期的生长以观察到的胎儿大小和预期的胎儿大小之间的差异表示，以胎龄天数表示，主要结果测量出生体重、妊娠持续时间和分娩小于胎龄儿的风险。出生体重增加28.2（95%置信区间14.6至41.2）g。通过调整妊娠持续时间（调整系数为17.1（6.6至27.5）g），这种关联大大减弱。进一步调整母亲的特征和妊娠并发症没有显着的效果。在孕早期，分娩小于胎龄婴儿的风险随着胎儿尺寸的增加而降低（一天的比值比增加0.87、0.81至0.94）。该协会是没有实质性的影响调整母亲的特点或并发症的pregnancy.Conclusion出生体重的变化可能会决定，至少部分，在怀孕后的第一个12周，通过影响分娩时间和胎儿生长速度的胎儿生长。
Objective To determine if first trimester fetal growth is associated with birth weight, duration of pregnancy, and the risk of delivering a small for gestational age infant.Design Prospective cohort study of 38 033 pregnancies between 1999 and 2003.Setting 15 centres representing major regions of the United States.Participants 976 women from the original cohort who conceived as the result of assisted reproductive technology, had a first trimester ultrasound measurement of fetal crown-rump length, and delivered live singleton infants without evidence of chromosomal or congenital abnormalities. First trimester growth was expressed as the difference between the observed and expected size of the fetus, expressed as equivalence to days of gestational age,Main outcome measures Birth weight, duration of pregnancy, and risk of delivering a small for gestational age infant.Results For each one day increase in the observed size of the fetus, birth weight increased by 28.2 (95% confidence interval 14.6 to 41.2) g. The association was substantially attenuated by adjustment for duration of pregnancy (adjusted coefficient 17.1 (6.6 to 27.5) g). Further adjustments for maternal characteristics and complications of pregnancy did not have a significant effect. The risk of delivering a small for gestational age infant decreased with increasing size in the first trimester, (odds ratio for a one day increase 0.87, 0.81 to 0.94). The association was not materially affected by adjustment for maternal characteristics or complications of pregnancy.Conclusion Variation in birth weight may be determined, at least in part, by fetal growth in the first 12 weeks after conception through effects on timing of delivery and fetal growth velocity.