title: A prospective observational study of early fetal growth velocity and its association with birth weight, gestational age at delivery, preeclampsia, and perinatal mortality.
abstract: OBJECTIVE
  We aimed to measure early fetal growth velocity and to correlate this with the birth weight, gestational age at delivery, and with the incidence of adverse pregnancy outcomes specifically preeclampsia and perinatal mortality.
  
  
  METHODS
  A data based prospective observational study, wherein sonographic biometry data and specific pregnancy outcome related data were collected from pregnant women's records, starting soon after their first antenatal visit. Early fetal growth velocity was measured using BPD growth between 11 and 14 weeks scan and anomaly scan and standardizing this by Z scoring.
  
  
  RESULTS
  Out of 607 fetuses, 41 (6.7%) were slow growing, 531 (87.4%) normally growing, and 35 (5.7%) fast growing (Z scoring <10th(,) 10-90th, and >90th percentiles respectively). As fetal growth velocity increased, the mean birth weight decreased from 2958.7±388.9 (<10th centile), 2742.1±576.6 (10-90th centile), to 2339.3±729.4 (>90th centile); and gestational age at delivery decreased from 38.5±1.3 (<10th centile), 37.5±2.1 (10-90th centile), to 36.4±2.2 (>90th centile), and both these trends were statistically significant (p<0.001).Faster growing fetuses had a higher risk of preterm delivery(spontaneous+indicated) compared to other 2 groups [OR 4.42 (2.18,8.98)], and slower growing fetuses had a higher risk of postdated deliveries compared to other 2 groups [OR 3.042 (1.44, 6.45)].We found no significant association between early fetal growth velocity and incidence of small for gestational age at birth/low birth weight at term, preeclampsia, and perinatal mortality.
  
  
  CONCLUSIONS
  Early fetal growth velocity between first and second trimesters, may be one of the important factors influencing ultimate birthweight and gestational age at delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, Karnataka State, India. akhilavasudeva@gmail.com
authors.forename: Akhila
authors.initials: A
authors.lastname: Vasudeva
authors.forename: Anu Annie
authors.initials: AA
authors.lastname: Abraham
authors.forename: Asha
authors.initials: A
authors.lastname: Kamath
mesh_terms: D001724:Birth Weight; D015897:Comorbidity; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000401:mortality*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007236:Infant, Small for Gestational Age; D008297:Male; D054238:Perinatal Mortality; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data