Les courbes de poids fœtales et néonatales et la restriction de croissance intra-utérine

Abstract

Intrauterine growth restriction indicates that a fetus is unable to achieve its growth potential. The individual growth potential is approximated by customization of growth charts. Neonatal growth charts rely on body weight measures at birth while fetal growth charts rely on body weight estimated from biometric measurements of the fetus. The neonatal and fetal growth charts are not equivalent and have different meanings for epidemiologists and clinicians. Fetal growth charts also assess fetal growth velocity, but individual assessment of fetal weight may be flawed by lack of precision. Neonatal charts are constructed based on data obtained in the whole population or in a subgroup without gestational diseases. The two types of neonatal charts markedly differ at low gestational ages as 30% of preterm infants present intrauterine growth restriction, usually due to maternal diseases. Even if intrauterine growth restriction is a risk factor of fetal mortality, neonatal mortality, and short- and long-term morbidity, the predictive value of the charts (whether or not they are customized) at an individual level is low and may be improved by additional investigations.