Application of First Trimester Screening in the Prognostication of Small for Gestational Age

Authors

1 Neonatal Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Midwifery, School of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran

3 Medical Teacher, Lebanese Medical University, Beirut, Lebanon

Abstract

Background: Fetal growth restriction is defined as the failure of the fetus to achieve its full growth potential. The present study aimed to investigate the application of first trimester screening in the prediction of small for gestational age (SGA).
Methods: This cohort study was conducted on the consecutive and unselected women with singleton pregnancies undergoing routine first-trimester examinations in a health center affiliated to Neyshabur University of Medical Sciences in Razavi Khorasan Iran during February 2014-March 2016. Subjects received a first-trimester visit by a physician, which included the entry of basic maternal characteristics, medical history, measurement of maternal weight and height, ultrasound examination for fetal anatomy, and measurement of crown-rump length to assess gestational age.
Results: SGA was significantly correlated with maternal age, parity, and body mass index. Furthermore, a significant association was observed between SGA and smoking habits in the mothers.
Conclusion: According to the results, first trimester screening was a useful method for the prediction of SGA.

Keywords


1. Lackman F, Capewell V, Gagnon R, Richardson B. Fetal umbilical cord oxygen values and birth to placental weight ratio in relation to size at birth. Am J Obstet Gynecol. 2001; 185(3):674-82.

 2. Gardosi J, Kady SM, McGeown P, Francis A, Tonks A. Classification of stillbirth by relevant condition at death (ReCoDe): population based cohort study. BMJ. 2005; 331(7525):1113–7.

3. Perinatal and Maternal Mortality Review Committee. Ninth annual report of the perinatal and maternal mortality review committee: reporting mortality 2013. Wellington: Health Quality and Safety Commission; 2015.

4. Barker DJ, Osmond C, Forsen TJ, Kajantie E, Eriksson JG. Maternal and social origins of hypertension. Hypertension. 2007; 50(3):565-71.

 5. Baschat AA. Neurodevelopment following fetal growth restriction and its relationship with antepartum parameters of placental dysfunction. Ultrasound Obstet Gynecol. 2011; 37(5):501–14.

6. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol. 2015; 213(6): 779-88.

 7. Parra-Saavedra M, Crovetto F, Triunfo S, Savchev S, Peguero A, Nadal A, et al. Placental findings in lateonset SGA births without Doppler signs of placental insufficiency. Placenta. 2013; 34(12): 1136-41.

 8. Morken NH, Klungsoyr K, Skjaerven R. Perinatal mortality by gestational week and size at birth in singleton pregnancies at and beyond term: a nationwide population-based cohort study. BMC Pregnancy Childbirth. 2014; 14:172.

9. Kristensen S, Salihu HM, Keith LG, Kirby RS, Fowler KB, Pass MA. SGA subtypes and mortality risk among singleton births. Early Hum Dev. 2007; 83(2):99-105.

 10. McCowan L, Horgan RP. Risk factors for small for gestational age infants. Best Pract Res Clin Obstet Gynaecol. 2009; 23(6):779-93. 11. Schrauwers C, Dekker G. Maternal and perinatal outcome in obese pregnant patients. J Matern Fetal Neonatal Med. 2009; 22(3):218-26.

12. Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009; 10(2):194-203.

 13. Huda SS, Brodie LE, Sattar N. Obesity in pregnancy: prevalence and metabolic consequences. Semin Fetal Neonatal Med. 2010; 15(2):70-6.

14. McDonald SD, Han Z, Mulla S, Beyene J; Knowledge Synthesis Group. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ. 2010; 341:c3428.

 15. Alberico S, Montico M, Barresi V, Monasta L, Businelli C, SoiniV, et al. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study. BMC Pregnancy Childbirth. 2014; 14:23. 16. Reynolds RM, Allan KM, Raja EA, Bhattacharya S, McNeill G, Hannaford PC, et al. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years. BMJ. 2013; 347:f4539.

 17. McIntire DD, Bloom SL, Casey BM, Leveno KJ. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med. 1999; 340(16): 1234-8.

18. Waterland R. Is epigenetics an important link between early life events and adult disease? Horm Res. 2009; 71(Suppl 1):13-6.

 19. Schlotz W, Phillips DI. Fetal origins of mental health: evidence and mechanisms. Brain Behav Immun. 2009; 23(7):905-16.

 20. Poon LC, Zaragoza E, Akolekar R, Anagnostopoulos E, Nicolaides KH. Maternal serum placental growth factor (PlGF) in small for gestational age pregnancy at 11(+0) to 13(+6) weeks of gestation. Prenat Diagn. 2008; 28(12):1110-5.

21. Crovetto F, Figueras F, Triunfo S, Crispi F, Rodriguez-Sureda V, Peguero A, et al. Added value of angiogenic factors for the prediction of early and late preeclampsia in the first trimester of pregnancy. Fetal Diagn Ther. 2014; 35(4):258-66.

22. Baghaie M, Adlshoar M, Pakseresht S, Kazemnejad A. Survey predictive factors of neonatal low birth weight in mothers referring to hospitals in Rasht. J Holist Nurs Midwifery. 2005; 15(2):33-8.

 23. Hafner E, Philipp T, Schuchter K, Dillinger‐Paller B, Philipp K, Bauer P. Second‐trimester measurements of placental volume by three‐dimensional ultrasound to predict small‐for‐gestational‐age infants. Ultrasound Obstet Gynecol. 1998; 12(2): 97-102.

24. Yusefi J, Mirzade M, Tavasoli Askari N. To study the prevalence of LBW and to determine the ratio preterm to IUGR during one year in 22 Bahman Hospital in Mashhad. Med Sci. 2014; 5(1):1-6. 25. Ndiaye O, Ba M, Diack-Mbaye A, Diouf L, Sow HD, Sylla A, et al. Risk factors for low birth weight: influence of maternal age, parity, gestational age, nutritional status and maternal pathology. Dakar Med. 1998; 43(2):188–90.

26. Aldous MB, Edmindon MB. Maternal age at first child birth and risk of low birth weight and preterm delivery in Washington state. JAMA. 1993; 270(21):2577-7.

27. Marica S, Lancaster J. Community public health nursing. 5th ed. London: Mosby Inc; 2000. P. 694-5.

28. Klufio CA, Kariwiga G, Macdonald R. Normal birth weight at port moresby general hospital: a retrospective survey of normal term births to determine birth weight distribution. P N G Med J. 1992; 35(1):10-6.