Fetal growth between the first and second trimesters and the risk of adverse pregnancy outcome.
OBJECTIVE
To relate growth rate of the biparietal diameter (BPD) between the first and second trimesters to the risk of perinatal death, intrauterine growth restriction (IUGR), macrosomia, preterm/post-term delivery and pre-eclampsia.


METHODS
In this retrospective study, we analyzed sonographic BPD measurements at 11-14 and 17-21 weeks from 8215 singleton pregnancies in the Copenhagen First Trimester Study. Growth rate was defined as millimeters of growth per day between the two measurements and was dichotomized into growth rates < 2.5(th) vs. 2.5(th)-97.5(th) centiles, and > 97.5(th) vs. 2.5(th)-97.5(th) centiles. Odds ratios (OR) and 95% CIs for adverse outcome were calculated.


RESULTS
Fetuses with growth rates < 2.5(th) centile had an OR of 4.79 (95% CI, 1.43-15.99) for perinatal death and an OR of 2.64 (95% CI, 1.51-4.62) for birth weight < sonographically estimated mean fetal weight (adjusted for gestational age) - 2 SD. Fetuses with growth rates > 97.5(th) centile had an OR of 2.83 (95% CI, 1.58-5.06) for birth weight > mean + 2 SD and an OR of 2.30 (95% CI, 1.15-4.59) for delivery in weeks 34-36. Growth rate showed no association with pre-eclampsia.


CONCLUSIONS
There is a significant relationship between the growth rate of BPD from the first to the second trimester and adverse pregnancy outcome. Low growth rates are associated with an increased OR for perinatal death and IUGR, while high growth rates are associated with an increased OR for macrosomia and preterm delivery.
Pedersen
N G
NG
Department of Fetal Medicine and Ultrasound, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Nina@ngpedersen.com
Wøjdemann
K R
KR
Scheike
T
T
Tabor
A
A
D000328:Adult; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D047928:Premature Birth; D012189:Retrospective Studies; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal