Abstract
BackgroundAccording to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes.MethodsFirst, second, and third trimester fetal ultrasound examinations were conducted between 2002 and 2012. The data was selected using the following criteria: routine examinations in uncomplicated singleton pregnancies, Caucasian ethnicity, and confirmation of gestational age by a crown-rump length (CRL) measurement in the first trimester. Generalized Additive Model for Location, Scale and Shape (GAMLSS) was used to align the time frames of the longitudinal fetal measurements, corresponding with the methods of the postnatal growth curves of the WHO MGRS Group.ResultsA total of 27,680 complete scans were selected from the astraia© ultrasound database representing 12,368 pregnancies. Gender-specific fetal growth curves for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were derived. The HC and BPD were significantly larger in boys compared to girls from 20 weeks of gestation onwards (p < 0.001) equating to a 3-day difference at 20–24 weeks. Boys were significantly heavier, longer, and had greater head circumference than girls (p < 0.001) at birth. The Apgar score at 1 min (p = 0.01) and arterial cord pH (p < 0.001) were lower in boys.ConclusionsThese longitudinal fetal growth curves for the first time allow integration with neonatal and pediatric WHO gender-specific growth curves. Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls. Gender difference in intrauterine growth is sufficiently distinct to have a clinically important effect on fetal weight estimation but also on the second trimester dating. Therefore, these differences might already play a role in early fetal or immediate neonatal management.
Highlights
According to the World Health Organization (WHO) Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth
Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls
We aimed to test the validity of these curves by comparing the estimated fetal weights derived from these charts to actual birth weight, and determine whether there were gender differences in fetal growth trajectories and immediate birth outcomes
Summary
According to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. It is widely known that boys are slightly larger than girls in the first trimester and at birth, there has been no consideration of fetal gender in the development and interpretation of fetal growth curves [5,6,7,8]. To derive information on fetal growth, statistical strategies using repeat measurements are required but longitudinal methodologies are utilized more rarely [20, 21] Given these complexities, the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) Group recommended Generalized Additive Model for Location, Scale and Shape (GAMLSS) for the construction of the WHO Growth Standards [22, 23]. Growth charts have been developed in the regions of Europe and the USA and customization based on ethnicity is reported [11, 12, 18, 19, 24]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
