IN-UTERO FETAL GROWTH PATTERNS IN RELATION TO OUTCOME AT BIRTH

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The project has been expanded to encompass two related research studies. The first study has analyzed data derived from a randomized clinical trial of diagnostic ultrasound use during pregnancy conducted by the team of Norwegian investigators in Trondheim, Norway. The purpose of the analysis is to examine fetal growth patterns using longitudinal measurements throughout pregnancy of: (1) symphyseal-fundal heights; (2) weight gain at each prenatal visit; (3) serial biparietal and abdominal diameter measurements from ultrasound; and (4) maternal hemoglobin level. Regression models have been fit to the serial measurements for each mother. The coefficients of the regressions have been analyzed in relation to various indicators of birth size such as weight, crown-heel length, ponderal index, and birth weight-for-gestational age percentile. Using an analysis of covariance procedure, additional factors (e.g., cigarette smoking, alcohol intake, low maternal prepregnancy weight, etc.) will be tested for significance in modifying intrauterine growth patterns. In addition to the study described above, a prospective study to determine risk factors for intrauterine growth retardation, or small-for-gestational age birth, was begun in 1984 through the research contract mechanism with both the University of Alabama in Birmingham and University of Trondheim, Norway (in collaboration with the Universities of Bergen and Uppsala). The study protocol includes recruitment of pregnant women before 17 weeks gestation. Those enrolled in the study will be carefully monitored throughout the remainder of their pregnancy. Symmetric and asymmetric forms of intrauterine growth retardation will be assessed prenatally and at delivery. Infants born to the study mothers will have follow-up exams during the first year of life to assess catch-up growth and attainment of early developmental milestones.