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INTRAUTERINE GROWTH RESTRICTION |
Ultrasound Obstet Gynecol. 1995 Sep;6(3):168-74.
An adjustable fetal weight standard.
Gardosi J, Mongelli M, Wilcox M, Chang A.
Department of Obstetrics and Gynaecology, University Hospital, Queen's
Medical Centre, Nottingham, UK.
The monitoring of fetal weight is an important aspect of antenatal care. To
construct an individually adjustable standard, we developed a model to link
the predicted birth weight to a fetal weight curve which outlines how this
weight is to be reached in an uncomplicated pregnancy. A formula was derived
which describes the median fetal weight at each gestation as a proportion of
the optimal term weight, and also defines the 90th and 10th centile curves
as normal limits. We analyzed a birth weight database of 38,114 singleton,
routine ultrasound-dated pregnancies resulting in term deliveries. By
stepwise multiple regression analysis, we derived coefficients for the
factors that act as variables on term birth weight in our population. Apart
from gestational age and sex, the maternal height, weight at first visit,
ethnic group, parity and smoking all have significant and independent
effects on birth weight. The variation due to ethnic group appears to be
physiological in this population. Smoking is associated with a reduction in
birth weight, which is independent of maternal physique and related to the
number of cigarettes per day as reported at the first visit. We have
developed a software program which calculates, on the basis of pregnancy
variables entered at the first visit, an adjusted normal range for fetal
size. This can be printed out as a chart and used for antenatal surveillance
of growth.
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