Early Pregnancy Screening for Intrauterine Growth Retardation

Abstract

Many factors which can be identified in early pregnancy have been reported to increase the risk of delivering a growth-retarded infant. In this prospective clinical study of an unselected area-based population, 15 previously reported risk factors for intrauterine growth retardation (Table 1) were recorded in the early stages of gestation. Women with such factors were then followed with respect to fetal growth and pregnancy outcome. The main purpose of the study was to determine the frequencies of the different factors and the risk increase when they are present. All pregnant Scandinavian women residing in Uppsala County, Sweden, were included in a screening program for the detection of risk factors. A woman was considered positive if she had one factor, and these women constituted the risk group. Registration of risk factors was accomplished before 18 completed weeks of gestation. Every fifth woman giving birth at the University Hospital of Uppsala (with certain exceptions) during 1980 was assigned to the control group. Figure 1 (a and b) illustrates birth weight in relation to gestational age in the risk and control groups, respectively. In the upper right quadrants, the number of infants with birth weights greater than 3000 gm and gestational ages greater than 36 weeks are given in figures (greater than 3000 gm roughly equals birth weight for gestational age greater than −1 SD at term, according to the Swedish growth curve). The same figure shows that mothers from the risk group are at higher risk than mothers from the control group to deliver babies with low birth weights and/ or low gestational ages. As shown in Figure 1 a, there were eight very premature infants (gestational age less than 30 weeks) delivered by mothers in the risk group. These infants survived the perinatal period, but one died after 11 days, due to asphyxia and prematurity.