Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study.
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.


METHODS
Prospective cohort study of 38 033 pregnancies between 1999 and 2003.


METHODS
15 centres representing major regions of the United States.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Bukowski
Radek
R
Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA. rkbukows@utmb.edu
Smith
Gordon C S
GC
Malone
Fergal D
FD
Ball
Robert H
RH
Nyberg
David A
DA
Comstock
Christine H
CH
Hankins
Gary D V
GD
Berkowitz
Richard L
RL
Gross
Susan J
SJ
Dugoff
Lorraine
L
Craigo
Sabrina D
SD
Timor-Tritsch
Ilan E
IE
Carr
Stephen R
SR
Wolfe
Honor M
HM
D'Alton
Mary E
ME
D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000502:physiology; D047928:Premature Birth / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors