Developing intrauterine growth curve from two Mayan populations in Guatemala

Abstract

Background The purpose of this study was to develop an equation for estimating gestational age using fetal ultrasound measurements specific to women living in the villages of Santiago Atitlán (SA) and San Lucas Tolimán (SLT), which sit in the Guatemalan highlands. Methods This study was a prospective observational study of a Guatemalan obstetric population. Cross-sectional design was used to collect baseline maternal characteristics, whereas fetal ultrasound measurements were collected longitudinally. Guatemalan women were continuously enrolled in this study from January 2010 to May 2013 from four clinics based in SA and SLT. Forward selection and mixed-effect modeling techniques were used. Guatemalan data were extrapolated to the Skupski linear mixed effect model, which was developed using ultrasounds obtained in the United States. Results 894 Guatemalan women enrolled in this study, with 460 of these women had known ultrasound biometrics. In the final model, 285 women contributed 376 ultrasound measurements, where the average number of ultrasound visits was slightly more than one visit. Conclusions The intrauterine growth curve generated from these two Mayan populations had notable divergence at later gestation from Skupski curve. This difference may be related to a genetic predisposition, selection bias, environmental factor, or other confounding unidentified variable. Application of this formula longitudinally would help to verify these findings and provide further clarification to the etiology of this possible difference.