Fetal Growth Rate Research Articles

Site -2548 of the leptin gene is associated with gender-specific trends in newborn size and cord leptin levels.

Circulating leptin levels positively correlate with adult BMI and size at birth. Previous studies found gender-specific associations between polymorphisms in the leptin gene and postnatal obesity-related traits or circulating leptin levels. We examined the relationships among leptin gene polymorphisms, size for gestational age, umbilical cord leptin, and gender. Six single nucleotide polymorphisms (SNPs) were genotyped in the leptin gene in 261 newborns (72 low birth weight Caucasians, 189 randomly-selected African-Americans). In African-Americans, umbilical cord leptin and free testosterone levels were measured. Linear regression was used to identify significant predictors of size for gestational age or cord leptin levels and gender x genotype interaction effects. There is a significant interaction between gender and genotype at site -2548 (A/G). Among low birth weight Caucasians, the A allele was associated with an increase in female size for gestational age, while the A allele was associated with decreased male birth size. Among African-Americans, the A allele was associated with a decrease in umbilical cord leptin in females and with an increase in cord leptin in males. Cord testosterone levels were not a significant predictor of cord leptin levels either among all African-American newborns or among strata of -2548 genotypes and gender. In male and female fetuses, site -2548 of the leptin gene may differently affect the expression level of the leptin gene or the rate of fetal growth. This gender-specific effect does not appear to be mediated by the level of free testosterone at delivery.

Fetal growth patterns in fetuses of women with pregestational diabetes mellitus

To assess the effect of glucose control on the rate of growth of fetuses in women with pregestational diabetes mellitus (Types 1 and 2). All pregestational diabetic women booked at Mater Mothers' Hospital, Brisbane, Australia, between 1 January 1994 and 31 December 2002, were included. Pregnancies with congenital fetal anomalies, multiple pregnancies, and pregnancies terminated prior to 20 weeks' gestation were excluded. Dating scans were performed before 14 weeks' gestation and serial scans were performed at 18, 24, 28, 32 and 36 weeks. Fetal parameters, including biparietal diameter, femur length and abdominal circumference, were recorded. The daily growth rates for biparietal diameter, femur length, and fetal abdominal area were calculated and compared with those in a low-risk (non-diabetic) population. The growth rates in fetuses of women with satisfactory diabetic control (HbA1c < 6.5%) and unsatisfactory control (HbA1c > or = 6.5%) in the three trimesters were compared. A total of 174 diabetic pregnancies were included and a total of 997 ultrasound scans were performed. The growth rates for fetuses of mothers with diabetes mellitus were significantly higher than for those in the low-risk population. The z-scores for biparietal diameter, femur length, and fetal abdominal area were 0.18, 0.59 and 1.44, respectively. Fetuses of diabetic mothers with high HbA1c in the first trimester had significantly greater fetal abdominal area growth rate than those with normal HbA1c (fetal abdominal area z-score of 1.7 vs. 0.75, P = 0.009). Although the fetal abdominal area z-scores in fetuses of diabetic mothers with high HbA1c in the second or third trimesters were also higher than those with normal HbA1c levels, the differences did not reach statistical significance. Maternal obesity did not influence the fetal growth rate. The rate of growth of fetuses of diabetic mothers differs from that of the normal population. Growth acceleration persists until the late third trimester. Moreover, periconceptional glucose control appears to have a significant effect on accelerated growth of the fetal abdominal area.

Biomedical Instruments for Fetal and Neonatal Surveillance

Specialised instruments have been developed to aid the care of the fetus and the newborn baby. Miniature sensors using optical, electrical, chemical, mechanical and magnetic principles have been produced for capturing key measurands. These include temperature, pressure, flow and dimension, as well as several specific molecules such as glucose, oxygen and carbon dioxide. During pregnancy ultrasound imaging and blood flow techniques provide valuable information concerning fetal abnormalities, fetal growth, fetal breathing and fetal heart rate. Signal processing and pattern recognition can be useful for deriving indicators of fetal distress and clinical status, based on biopotentials as well as ultrasound signals. Fetal pH measurement is a critical requirement during labour and delivery. The intensive care of ill preterm babies involves provision of an optimal thermal environment and respiratory support. Monitoring of blood gas and acid-base status is essential, and this involves both blood sampling for in vitro analysis as well as the use of invasive or non-invasive sensors. For the future it will be vital that the technologies used are subjected to controlled trials to establish benefit or otherwise.

Hb A1c in relation to intrauterine growth among male adolescents in southern Brazil

The fetal origins hypothesis states that nutritional deprivation in utero affects fetal development and contributes to the incidence of diseases associated with the metabolic syndrome in later life. This study investigated whether haemoglobin (Hb) A(1c), an indicator of blood glucose, varied among healthy male adolescents according to their fetal growth rate, in a middle-income setting. Participants were men aged 18 years, belonging to the 1982 Pelotas birth cohort. Complete data, including gestational age and Hb A(1c) at age 18 years, were available for 197 individuals. There was an inverse association between mean Hb A(1c) and birthweight for the gestational age, but not birthweight alone. The association remained significant after adjustment for family income and mother's education, as well as for body mass index at 18 years (P for trend=0.01 and 0.03, respectively).

Maternal and Paternal Influences on Length of Pregnancy

Biological evidence suggests that both mother and fetus are involved in triggering a normal delivery. A tendency of a child to have a gestational age at birth similar to the father's could represent the effect of genes passed from the father to the fetus. Similar tendencies between mother and child could represent maternal genes passed to the fetus, as well as genes to the mother received from the grandmother that affect a woman's capacity to carry a pregnancy. The Medical Birth Registry of Norway contains data on all births in Norway from 1967 onward. We identified 77,452 pairs of boys and girls born at term who later became parents and linked their birth data to the birth records for their first child. Gestational age of the child at birth increased on average 0.58 days for each additional week in the father's gestational age (95% confidence interval 0.48-0.67) and 1.22 days for each additional week in the mother's gestational age (1.21-1.32). Gestational age was, however, 0.65 days reduced for each additional kilogram in the father's birth weight, presumably due to more rapid growth of the fetus triggering delivery. Initiation of delivery has a fetal component that is heritable (passed from father and mother to child) and an additional maternal component that is also heritable. In addition, a more rapid rate of fetal growth appears to trigger delivery at earlier gestation. II-2.

The role of the placenta in the developmental origins of health and disease—Implications for practice

The placenta is actively involved in transporting nutrients to the fetus, it has both direct and indirect effects on fetal cardiovascular function and has endocrine influences on the mother and fetus. As such, a properly functioning placenta is crucial for normal fetal development and plays a central role in mediating effects of the maternal environment on the fetus. An altered external environment or abnormal placental function can induce developmental changes in the fetus and may have important consequences for the risk of cardiovascular and metabolic disease in adult life. The developmental origins hypothesis proposes that the early environment, from the periconceptional period until early childhood, can predispose an individual to adult cardiovascular and metabolic disease. This hypothesis is supported by epidemiological studies and by work in animals. These effects do not just act in low birth weight babies but have been shown to occur within the normal range of birth weight. It is thought that fetal adaptations to an impaired intra-uterine environment may enhance survival in early life but have deleterious effects in later life. Experimental studies suggest that maternal diet and body composition can alter placental structure and function, and we have recently demonstrated associations between a woman's nutritional state before pregnancy and placental function at term. To elucidate these relationships, further work is needed to define markers of placental function and to characterize their relation to rates of fetal growth. Understanding how the placenta mediates maternal influences will be crucial in determining the mechanisms underlying developmental programming. This will allow the design of targeted public health interventions, both before and during pregnancy, to enhance placental function and thereby improve the health of the offspring throughout life.

Developmental programming of health and disease

The environment encountered in fetal and neonatal life exerts a profound influence on physiological function and risk of disease in adult life. Epidemiological evidence suggests that impaired fetal growth followed by rapid catch-up in infancy is a strong predictor of obesity, hypertension, non-insulin-dependent diabetes and CHD. Whilst these associations have been widely accepted to be the product of nutritional factors operating in pregnancy, evidence from human populations to support this assertion is scarce. Animal studies clearly demonstrate that there is a direct association between nutrient imbalance in fetal life and later disease states, including hypertension, diabetes, obesity and renal disease. These associations are independent of changes in fetal growth rates. Experimental studies examining the impact of micro- or macronutrient restriction and excess in rodent pregnancy provide clues to the mechanisms that link fetal nutrition to permanent physiological changes that promote disease. Exposure to glucocorticoids in early life appears to be an important consequence of nutrient imbalance and may lead to alterations in gene expression that have major effects on tissue development and function. Epigenetic mechanisms, including DNA methylation, may also be important processes in early-life programming.

Deep, prolonged torpor by pregnant, free-ranging bats

Many mammals save energy during food shortage or harsh weather using controlled reductions in body temperature and metabolism called torpor. However, torpor slows offspring growth, and reproductive individuals are thought to avoid using it because of reduced fitness resulting from delayed offspring development. We tested this hypothesis by investigating torpor during reproduction in hoary bats (Lasiurus cinereus, Vespertilionidae) in southern Canada. We recorded deep, prolonged torpor bouts, which meet the definition for hibernation, by pregnant females. Prolonged torpor occurred during spring storms. When conditions improved females aroused and gave birth within several days. Our observations imply a fitness advantage of torpor in addition to energy conservation because reduced foetal growth rate could delay parturition until conditions are more favourable for lactation and neonatal survival.

A trade-off between early growth rate and fluctuating asymmetry in Brazilian boys

Right-left discrepancies in normally symmetrical traits are assumed to result from inability of the individual to buffer environmental and genetic stresses. Fluctuating asymmetry (FA) may therefore signal the quality of an individual to potential mates, or to parents during early life. FA could signal the heritable ability to buffer stress-the 'good genes' hypothesis. Alternatively, FA could signal the degree of within-lifetime exposure to stress, in particular during specific sensitive periods of development--the 'good development' hypothesis. We tested the hypotheses that FA at 9 years of age is positively related to (a) fetal growth rate, (b) early infant growth rate, and (c) total post-natal growth rate. FA, weight and height were measured in a sample of 172 boys aged 9 years from Pelotas, Brazil, who had previous measurements of weight and height at birth and 6 months. Fetal growth was not related to FA, however FA was positively related to total weight gain after birth (p < 0.05). This association could be broadly attributed to weight gain in the first 6 months of post-natal life (p = 0.075). Those currently obese had significantly greater FA than those non-obese (p < 0.05). Our results support the 'good development' hypothesis, and suggest that growth rate during an early post-natal critical window, previously linked to numerous health outcomes, also has long-term effects on FA.

The Hispanic Paradox in Twin Pregnancies

The objective of this study was to compare length of gestation, fetal growth, and birthweight by race/ethnicity and pregravid weight groups in twin pregnancies. Three thousand and thirty-six twin pregnancies of 28 weeks or more gestation were divided by race/ethnicity (White, Black and Hispanic), and pregravid body mass index (BMI) groups (less than 25.0 vs. 25.0 or more). Outcomes were modeled using multiple regression, controlling for confounders, with White non-Hispanic women as the reference group. Hispanic women had the highest average birthweight and the longest gestation, as well as the lowest proportions of low birthweight, very low birthweight, preterm and early preterm births of the 3 race/ethnicity groups. In the multivariate analyses, Hispanic women had significantly longer gestations (by 7.8 days) and faster rates of fetal growth midgestation (20 to 28 weeks, by 17.4 g/week) and late gestation (after 28 weeks, by 5.3 g/week), whereas Black women had significantly slower rates of fetal growth (by 5.7 g/week and by 4.5 g/week, respectively). These findings in twins reflect the racial and ethnic disparities previously shown in singletons, including the Hispanic paradox of longer gestations and higher rates of fetal growth.

The Hispanic Paradox in Twin Pregnancies

AbstractThe objective of this study was to compare length of gestation, fetal growth, and birthweight by race/ethnicity and pregravid weight groups in twin pregnancies. Three thousand and thirty-six twin pregnancies of 28 weeks or more gestation were divided by race/ethnicity (White, Black and Hispanic), and pregravid body mass index (BMI) groups (less than 25.0 vs. 25.0 or more). Outcomes were modeled using multiple regression, controlling for confounders, with White non-Hispanic women as the reference group. Hispanic women had the highest average birthweight and the longest gestation, as well as the lowest proportions of low birthweight, very low birthweight, preterm and early preterm births of the 3 race/ethnicity groups. In the multivariate analyses, Hispanic women had significantly longer gestations (by 7.8 days) and faster rates of fetal growth midgestation (20 to 28 weeks, by 17.4 g/week) and late gestation (after 28 weeks, by 5.3 g/week), whereas Black women had significantly slower rates of fetal growth (by 5.7 g/week and by 4.5 g/week, respectively). These findings in twins reflect the racial and ethnic disparities previously shown in singletons, including the Hispanic paradox of longer gestations and higher rates of fetal growth.

Fetal growth rates and the very preterm delivery of twins

Our objective was to determine whether slow fetal growth rates and twin growth patterns from 20 weeks' gestation to delivery are associated with very preterm delivery. Available charts were reviewed for twin pregnancies, delivered between 1979 and 2002, at 4 U.S. medical centers. The sample of 1612 pregnancies delivered at 28 week's gestation or greater and had at least 2 ultrasound evaluations of fetal size from 20 to 28 weeks or from 28 weeks to delivery for estimation of fetal growth rates (grams per week). Slow fetal growth (below the 10th percentile) was defined as less than 90 grams per week at 20-28 weeks and 168 g/week from 28 weeks to delivery. The main outcome measure was the timing of delivery. Of the women delivering twins, 5.3% delivered extremely preterm (28-30 weeks), 8.5% very preterm (31-32 weeks), and 40.1% preterm (33-36 weeks). Patterns of growth for the pair were highly associated with very preterm delivery. Compared with neither growing slowly (1.7%), 4.9% delivered very preterm if only 1 twin grew slowly. Very preterm was 14.6% (adjusted odds ratio 9.81; 95% confidence interval, 3.50-27.48) with both growing slowly from 28 weeks on and 20.0% (adjusted odds ratio 15.04; 95% confidence interval 5.13-44.11) with both growing slowly over both intervals. Survival analyses indicated that twins with normal growth in both intervals remained undelivered for a significantly longer number of days (P < .0001) than pairs in which one or both twins were growing slowly. Very preterm delivery of twins seems to be preceded by slowed or compromised fetal growth for the pair.

FUNCTIONAL SYSTEM “MOTHER-PLACENTA-FETUS“- DAILY BIORHYTHMS IN NORMAL AND COMPLICATED PREGNANCY

Purpose: The aim of our work was to study daily biorhythms of maternal and fetal blood flow, contractile activity of uterus, rates of fetal growth at normal pregnancy and threat of premature delivery.

Neonatal Nutrition and Consequences on Adult Health

After completing this article, readers should be able to: 1. Describe aberrations in adult health that can result from nutrition in the fetal period and in neonatal life. 2. Review the results of studies from human neonates regarding early nutritional interventions designed for “catch-up” growth. 3. Review results from animal studies regarding early nutrition and “programming” for adult metabolic syndrome. 4. Describe some of the potential epigenetic mechanisms that may be responsible for “programming.” 5. Examine methods for preventing growth delays, the consequences of undernutrition, and the metabolic syndrome related to adverse “programming.” One of the traditional goals of neonatal nutrition is to maintain growth within standardized limits. In the preterm infant, growth between the 10th and 90th percentiles of intrauterine rate has been an ideal goal. More recently, maintenance of lean body mass and bone density; prevention of complications such as chronic lung disease, necrotizing enterocolitis, and infection; and optimization of neurodevelopment and adult health through early nutritional programming have become recognized as more meaningful goals than mere somatic growth. To meet these goals, current nutritional practices require thorough scrutiny in terms of quantity and quality (composition) and how they are customized, if not for the individual patient (which would be ideal), at least for subgroups such as those who are small or appropriate for gestational age, sick or healthy, preterm or term, or male or female. Fetal nutrition and development frequently are used as a template for the low-birthweight infant. A large body of literature on the consequences of fetal undernutrition shows that infants born small for gestational age (SGA) not only have short-term morbidity, but long-term morbidity manifested in what has been termed the “metabolic syndrome.” This syndrome includes abdominal obesity, arterial hypertension, and insulin resistance. Other clinical manifestations can be observed, including thyroid dysfunction, hirsutism, ovarian hyperandrogenism and infertility, dyslipidemia (increased …

Foetal growth in north‐west Atlantic grey seals ( Halichoerus grypus )

The timing of implantation, duration of gestation and energetic costs associated with foetal development were examined in the north-west Atlantic grey seal Halichoerus grypus. Implantation occurs between 5 and 8 May. Active gestation lasts for 259–272 days and the duration of suspended development is 78–91 days. The duration of active gestation was slightly shorter among north-east Atlantic grey seals (238–255 days), while suspended development was longer (95–112 days). The rate of foetal growth increased in August, 3 months after attachment, until mid December when it began to slow once again, c. 1 month before parturition. During August, the placenta to foetus mass ratio was about 0.3, but declined to around 0.07 near birth. Foetal energy density increased rapidly reaching asymptotic levels of 22.6 kJ g−1 (dry weight) 3–4 months after implantation. Energy density of the placenta changed only slightly throughout gestation increasing from c. 21.7 to 23 kJ g−1 (dry weight) by the autumn. Energy costs associated with foetal growth are c. 648 MJ.

The influence of mating system on the intensity of parent–offspring conflict in primates

An evolutionary conflict of interest exists between parents and their offspring over the partitioning of parental investment (PI) among siblings. When the direct fitness benefits to offspring of increased PI, outweigh the inclusive fitness costs from lost future sibling fitness, selection should favour the evolution of offspring selfishness over altruism. In theory, this conflict is heightened when females are not strictly monogamous, as current offspring should be less altruistic towards future half-siblings than they would be towards full-siblings. Using data collected on foetal growth rate (representing prenatal PI) in primates, I test the prediction from theory that the resolution of the parent-offspring conflict will be closer to the offspring's evolutionary optima in polyandrous species than in more monandrous species. Using phylogenetic comparative analysis, and controlling for allometry, I show that offspring are able to obtain more PI when the probability of future full-siblings decreases, and that this is most pronounced in taxa where there is the opportunity for direct foetal access to the maternal bloodstream. These results support the hypothesis that the resolution of prenatal PI conflict is influenced by both a species' mating system and by its placental structure.

206. Effect of in vitro embryo culture on placental gene expression in the sheep

In vitro culture (IVC) systems feature commonly in reproductive technologies used in livestock. However, these culture conditions impact on the metabolism and physiology of the developing embryos, as well as on fetal outcome. Culturing rodent embryos in simple defined media results in decreased postimplantation viability and fetal growth rate.1,2 Cytokines and growth factors are present in vivo but are absent from culture and may be causal in the perturbed fetal growth observed. Furthermore, the occurrence of large offspring syndrome (LOS) following embryo IVC in ruminants has been reported and is associated with loss of genetic imprinting.3,4 Abnormal placental development following IVC is also likely to involve perturbed expression of imprinted genes including insulin-like growth factor II (IGF2) and its receptor (IGF2R). The IVC system used for this study included a control embryo transfer group without culture (ET, n = 11), in vitro cultured embryos in serum free defined medium (IVC-NS, n = 10) and in vitro cultured embryos in defined medium with human serum (IVCHS, n = 8). The cultured embryos were transferred to recipient ewes and placentomes were collected at 144–145 days gestation. Fetal weight (kg) was increased in IVCHS (5.15 ± 0.28) compared to ET (4.12 ± 0.24, P = 0.017) and IVC-NS (4.36 ± 0.27). Real-time RT-PCR was used to quantify IGF2 and IGF2R mRNA expression normalized to housekeeper RpP0. Although IGF2 expression was increased in the IVCHS group (2.27 ± 0.44) when compared to ET (1.22 ± 0.37) and IVC-NS (1.17 ± 0.43) groups, this was not significant. In addition, IGF2R expression was increased in the IVCHS (0.008 ± 0.003) group compared to ET (0.003 ± 0.001) and IVC-NS (0.004 ± 0.001) groups, but this was also not significant. IGF2 and IGF2R expression were, however, positively correlated in IVCNS (r = 0.72) and IVCHS (r = 0.95) placentomes, but not control ET placentomes. The presence of serum in IVC promoted fetal growth and increased expression of IGF2 and IGF2R mRNA in placental tissue. Comparison of placental gene expression from IVCHS and naturally mated pregnancies would be valuable to assess the role of serum in placental and fetal development. (1)Bowman &amp; McLaren, 1970.(2)Kaye &amp; Gardner, 1999.(3)Thompson et al., 1995.(4)Young et al., 1998.

Gender mix in twins and fetal growth, length of gestation and adult cancer risk

This study evaluated the effect of gender mix (the gender combinations of twin pairs) on fetal growth and length of gestation, and reviewed the literature on the long-term effects of this altered fetal milieu on cancer risk. In singletons, it is well established that females weigh less than males at all gestations, averaging 125-135 g less at full term. This gender difference is generally believed to be the result of the effect of androgens on fetal growth. The gender difference in fetal growth is greater before the third trimester and less towards term, with males growing not only more, but also earlier than females. Plurality is a known risk factor for reduced fetal growth and birthweight. Compared with singletons, the mean birthweight percentiles of twins fall substantially (by 10% or more) below the singleton 10th percentile by 28 weeks, below the singleton 50th percentile by 30 weeks, and below the singleton 90th percentile by 34 weeks. In unlike-gender twin pairs, it has been reported that the female prolongs gestation for her brother, resulting in a higher birthweight for the male twin than that of like-gender male twins. Other researchers have demonstrated that females in unlike-gender pairs had higher birthweights than females in like-gender pairs. Analyses from our consortium on 2491 twin pregnancies with known chorionicity showed longer gestations and faster rates of fetal growth in both males and females in unlike-gender pairs compared with like-gender male or female pairs, although these differences were not statistically significant. The post-natal effects for females growing in an androgenic-anabolic environment include increased sensation-seeking behaviour and aggression, lowered visual acuity, more masculine attitudes and masculinising effects of the auditory system and craniofacial growth. In contrast, there is no evidence to suggest that there might be a similar feminising effect on males from unlike-gender pairs. This hormonal exposure in utero may influence adult body size and susceptability to breast cancer.

Late Life Metabolic Syndrome, Early Growth, and Common Polymorphism in the Growth Hormone and Placental Lactogen Gene Cluster

Low rates of fetal and infant growth are associated with the metabolic syndrome and cardiovascular disease in later life. We investigated common genetic variation in the GH-CSH gene cluster on chromosome 17q23 encoding GH, placental lactogens [chorionic somatomammotropins (CSH)], and placental GH variant in relation to fetal and infant growth and phenotypic features of the metabolic syndrome in subjects aged 59-72 yr from Hertfordshire, UK. Allele groups T, D1, and D2 of a locus herein designated CSH1.01 were examined in relation to GH-CSH single nucleotide polymorphisms and to specific phenotypes. Average birth weights were similar for all genotype groups. Men with T alleles were significantly lighter at 1 yr of age, shorter as adults, and had higher blood pressures, fasting insulin (T/T 66% higher than D2/D2) and triglyceride concentrations, and insulin and glucose concentrations during a glucose tolerance test. Birth weight and 1-yr weight associations with metabolic syndrome traits were independent of the CSH1.01 effects. Common diversity in GH-CSH correlates with low 1-yr weight and with features of the metabolic syndrome in later life. GH-CSH genotype adds substantially to, but does not account for, the associations between low body weight, at birth and in infancy, and the metabolic syndrome.

P08.14: Ultrasound derived fetal growth curves for a Jamaican population

The objective of this study was to develop fetal growth curves and percentile growth charts for a Jamaican population. Four hundred and ninety-nine Jamaican women of African origin were enrolled in a prospective study from the antenatal clinic of the University Hospital of the West Indies, Kingston, Jamaica. Serial ultrasound scans were performed between 14 and 37 weeks gestation to measure fetal growth. The ultrasound measurements performed were biparietal diameter, head and abdominal circumference and femoral length. A total of 2574 ultrasound scans were performed on the 499 women (mean 5.2 per woman). From these data, centiles for fetal growth curves for the four fetal measurements were constructed and percentile tables were created for a Jamaican population. Birthweight varies between ethnic groups and, therefore, so must fetal growth rates. At present, fetal growth in Jamaica is assessed using standards which are based on data derived from Caucasian populations. Fetal growth curves using data from this study would more accurately identify a fetus that is at risk and hence, provide information which could improve obstetric care. These new growth curves should provide data, which will improve obstetric decision making.