Typical Fetal Weight Increase
A recent study has shown that embryonic growth in the first trimester can influence the final growth velocity in the subsequent trimesters and even final birth weight. A study has shown that risks of preterm birth in low abnormal birth weight (intrauterine growth restriction) are 2- to 3-fold greater than the risk among appropriate-for-gestational-age infants. A placenta previa study has shown low birth weight is due mainly to preterm delivery and to a lesser extent with fetal growth restriction.
(More? HSTAT - Management of Preterm Labor)
Page Links: Introduction | Some Recent Findings | First Trimester Growth | Second and Third Trimester Growth | Birthweight | Fetal Weight Graph | References | Glossary
Related Pages: Abnormal Development - Fetal Origins Hypothesis
Perinatal Risk Factors for Diabetes in Later Life. Kaijser M, Edstedt Bonamy AK, Akre O, Cnattingius S, Granath F, Norman M, Ekbom A. Diabetes. 2008 Dec 9.
"Low birth weight is consistently associated with an increased risk of non-insulin dependent diabetes mellitus in adulthood, but the individual contributions from poor fetal growth and preterm birth are not known. ....Our results suggest that the association between low birth weight and diabetes is due to factors associated with both poor fetal growth and short gestational age."
Bukowski R, Smith GC, Malone FD, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D'Alton ME; FASTER Research Consortium. Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study. BMJ. 2007 Apr 21;334(7598):836.
"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."
References:
Bukowski R, Smith GC, Malone FD, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D'Alton ME; FASTER Research Consortium. Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study. BMJ. 2007 Apr 21;334(7598):836.
Smith GC, Smith MF, McNay MB, Fleming JE. First-trimester growth and the risk of low birth weight. N Engl J Med. 1998 Dec 17;339(25):1817-22.
There has been a overall increase in mean singleton birthweights in the last 20 years. Recent changes in mean birthweights (1980 - 2003) from Scottish Data.
Reference: Centile charts for birthweight for gestational age for Scottish singleton births. Bonellie S, Chalmers J, Gray R, Greer I, Jarvis S, Williams C. BMC Pregnancy Childbirth. 2008 Feb 25;8:5.
Perinatal care at the borderlines of viability: a consensus statement based on a NSW and ACT consensus workshop (February 2005) published in The Medical Journal of Australia 2006; 185 (9): 495-500.
< 23 weeks survival is minimal and the risk of major morbidity is so high that initiation of resuscitation is not appropriate.
23 weeks active treatment may be discussed, but would be discouraged in NSW/ACT neonatal intensive care units.
23 to 25 weeks otherwise normal infant, there is an increasing obligation to treat. However, it is acceptable medical practice not to initiate intensive care if parents so wish, following appropriate counselling.
24 weeks antenatal transfer to a tertiary centre for fetal reasons is indicated. The option of non-initiation of intensive care/resuscitation should be offered.
25 weeks active treatment is usually offered, but the option of non-initiation of intensive care/resuscitation (presence of adverse fetal factors such as twin-to-twin transfusion, intrauterine growth restriction or chorioamnionitis) should also be discussed.
26 weeks + otherwise normal infant the obligation to treat is very high, and treatment should generally be initiated unless there are exceptional circumstances.
(modified extract from Workshop Consensus Statement)
Links: eMJA Consensus Statement |
Links: Reviews | Articles | Online Textbooks | Search Textbooks | Search PubMed | Glossary
Reviews
Hack M, Fanaroff AA. Outcomes of children of extremely low birthweight and gestational age in the 1990's. Early Hum Dev. 1999 Jan;53(3):193-218.
Articles
Centile charts for birthweight for gestational age for Scottish singleton births. Bonellie S, Chalmers J, Gray R, Greer I, Jarvis S, Williams C. BMC Pregnancy Childbirth. 2008 Feb 25;8:5.
Lackman F, Capewell V, Richardson B, daSilva O, Gagnon R. The risks of spontaneous preterm delivery and perinatal mortality in relation to size at birth according to fetal versus neonatal growth standards. Am J Obstet Gynecol. 2001 Apr;184(5):946-53.
Ananth CV, Demissie K, Smulian JC, Vintzileos AM. Relationship among placenta previa, fetal growth restriction, and preterm delivery: a population-based study. Obstet Gynecol. 2001 Aug;98(2):299-306.
Bukowski R, Smith GC, Malone FD, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D'Alton ME; FASTER Research Consortium. Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study. BMJ. 2007 Apr 21;334(7598):836.
Smith GC, Smith MF, McNay MB, Fleming JE. First-trimester growth and the risk of low birth weight. N Engl J Med. 1998 Dec 17;339(25):1817-22.
Search PubMed: May 2007 "low birth weight" 22,880 reference articles of which 2,285 were reviews.
Search PubMed Now: low birth weight | premature birth
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Page under development (notice removed when complete)
This page introduces concepts related to low birth weight and the neonate and should give you a feel for the topic.
See also notes on Fetal Growth , Fetal Development and Abnormal Development - Fetal Origins Hypothesis
Please email Dr Mark Hill if you wish to make a comment about this current project.
