Fetal Gestational Age Research Articles

Antenatal Ultrasound Measurement of Fetal Abdominal Subcutaneous Tissue Thickness as a Predictor of Fetal Birth Weight

Abstract Objectives To correlate fetal abdominal subcutaneous tissue thickness (FASTT) measured by transabdominal ultrasound and birth weight measured immediately after delivery and to obtain cut-off values for FASTT to predict small and large for gestational age babies in the Egyptian population. Background Fetal weight estimation is a crucial part of antenatal and intrapartum care as it forms the basis for decision making in obstetric care. Various studies compared the accuracy of different ultrasound fetal weight estimation formulas to determine the most accurate one, but current evidence still indicates significant error levels. FASTT measurement can be used to improve ultrasonographic fetal weight assessment reducing potential perinatal complications associated with small and large for gestational age fetuses. Patients and Methods A prospective cohort study conducted in Ain Shams University Hospitals on 86 pregnant women with normal singleton pregnancies between 24 and 40 weeks of gestation. FASTT was measured in millimeters at the anterior third of the abdominal circumference and birth weight was recorded immediately after delivery. Results This study concluded that FASTT showed high statistically significant correlation with EFW by Hadlock formula IV (1985) (r = 0.624, p- value = <0.001) and BW (r = 0.749, p- value = <0.001). FASTT showed higher sensitivity (84.09%) than specificity (64.29%) as a predictor of both SGA and LGA, but it showed higher sensitivity and specificity in LGA (sensitivity 100%, specificity 97.5%) compared to SGA (sensitivity 81.1%, specificity 73.5%). The best cut-off value of FASTT for LGA was 7.1 mm and that of SGA was 4.9 mm. No statistically significant correlation was found between FASTT and any of the maternal age, fetal gender or mode of delivery. Conclusion FASTT can be used as a predictor for birth weight; it is a better indicator of LGA than SGA. FASTT can be incorporated into fetal weight estimation formulas as a method to increase their accuracy especially at birth weight extremes. A study on a larger scale of Egyptian population should be conducted to generate fetal weight estimation formulas based on the Egyptian ethnicity to be the reference for medical practice in Egypt.

Comparative characteristics of the dimensions of the pons with the dimensions of the head in human fetes of different gestational age

Annotation. Malformations of human fetuses brains occur in 2-3 cases per 1000 pregnancies and are one of the most common reasons for termination of pregnancy, therefore prenatal diagnosis is extremely important and is aimed at further genetic testing of the fetus and detailed counseling of parents regarding the risk of recurrence. Anthropometric parameters of human fetuses heads allow monitoring the growth of the fetus, estimating the term of pregnancy and determining the method of birth of a pregnant woman. Therefore, the parameters of the head of human fetuses are one of the most important biological characteristics during prenatal research. The purpose of our scientific work is to determine the dimensions of the pons in human fetuses of different gestational ages and compare them with the dimensions of the head. Anatomical research was conducted on 146 human fetuses from 9-10 to 39-40 weeks of gestation. The material for the study was obtained from the maternity hospitals of the city of Vinnytsia and from the communal non-profit enterprise “Vinnytsia Regional Pathological Bureau of the Vinnytsia Regional Council”, and the study was conducted on stillborns who died from various causes not related to brain diseases in relatively healthy mothers. Head circumference, head height, longitudinal and transverse dimensions of the head, pons height, pons width, pons thickness were measured using a ShTs-125 caliper. Statistical processing of digital values was performed using the standard Statsoft software package “Statistica 6.0” on a personal computer using Microsoft Excel 2016, Kolmagorov-Smirnov and Shapiro-Wilk test indicators were determined and histograms were built based on them for visual assessment of the distribution of features. The head circumference of human fetuses of 39-40 weeks compared to fetuses of 9-10 weeks became 5.2 times larger, the longitudinal size of the head – 5 times, the transverse size of the head – 4.9 times, the height of the head – 3.6 times (p<0.01). The height of the pons in human fetuses of 39-40 weeks compared to fetuses of 9-10 weeks became 3.8 times greater, thickness – 3.6 times, width – 3.1 times (p<0.01).

Accuracy Evaluation of Fetal Foot Length and Correlation with Biparietal Diameter for Ultrasonographic Fetal Age Estimation in Uncomplicated Pregnant Women of Chattogram, Bangladesh

Background: Prediction and visual representation of developmental milestones of a growing fetus is most accurately done by ultrasonography. The present study was aimed to evaluate the correlation and accuracy of fetal foot length with fetal biparietal diameter to estimate fetal gestational age in Bangladeshi uncomplicated pregnant women of Chattogram district. Materials and methods: This cross-sectional observational study was conducted on 200 uncomplicated pregnant women of 15th to 28th weeks of gestation during the period from October 2021 to September 2022 in the Department of Anatomy, Chittagong Medical College, Chattogram. Fetal biometric parameters such as fetal foot length and biparietal diameter were measured by ultrasonography. For statistical analysis, Pearson’s correlation test and correlation-regression analysis was done and p-value was considered significant if it was <0.05 at 95% level of confidence. Results: Pearson’s correlation test showed that gestational age had strong positive and highly significant (p=0.000) correlation with both fetal foot length and biparietal diameter. The relation between gestational age and fetal foot length(r=0.986) is less strong than the relation between gestational age and biparietal diameter(r=0.988). Conclusion: This study revealed relationship between fetal foot length and gestational age regarding accuracy. Ultrasonographic measurement of fetal foot length can be practiced alongside traditional biometric parameters for pregnancy dating in modern medical science. IAHS Medical Journal Vol 6(2), December 2023; 35-39

Prediction of fetal brain gestational age using multihead attention with Xception

Accurate gestational age (GA) prediction is crucial for monitoring fetal development and ensuring optimal prenatal care. Traditional methods often face challenges in terms of precision and prediction efficiency. In this context, leveraging modern deep learning (DL) techniques is a promising solution. This paper introduces a novel DL approach for GA prediction using fetal brain images obtained via magnetic resonance imaging (MRI), which combines the strength of the Xception pretrained model with a multihead attention (MHA) mechanism. The proposed model was trained on a diverse dataset comprising 52,900 fetal brain images from 741 patients. The images encompass a GA ranging from 19 to 39 weeks. These pretrained models served as feature extraction components during the training process. The extracted features were subsequently used as the inputs of different configurable MHAs, which produced GA predictions in days. The proposed model achieved promising results with 8 attention heads, 32 dimensionality of the key space and 32 dimensionality of the value space, with an R-squared (R2) value of 96.5 %, a mean absolute error (MAE) of 3.80 days, and a Pearson correlation coefficient (PCC) of 98.50 % for the test set. Additionally, the 5-fold cross-validation results reinforce the model's reliability, with an average R2 of 95.94 %, an MAE of 3.61 days, and a PCC of 98.02 %. The proposed model excels in different anatomical views, notably the axial and sagittal views. A comparative analysis of multiple planes and a single plane highlights the effectiveness of the proposed model against other state-of-the-art (SOTA) models reported in the literature. The proposed model could help clinicians accurately predict GA.

Seeking the optimal gestational weight gain according to the pre-pregnancy body mass index: a cross-sectional study from Shanghai, China.

Maternal nutritional status is closely related to fetal intrauterine development and an abnormal birth weight increases various disease risks across life stages. To better guide pregnancy weight gain, we aimed to explore the optimal weight gain for pregnant women with different body mass indexes (BMIs). This retrospective cohort study included 68,981 women with singleton live birth between January 2017 and October 2021 in maternity centres in Shanghai, China. The fluctuations of the incidence of small and large for gestational age (small for gestational age (SGA) and LGA, respectively) were recorded at different maternal pre-pregnancy BMI (p-BMI) and different gestational weight gain (GWG) groups to find the lowest point of abnormal fetal weight incidence. The optimal GWG was then determined using a linear regression equation. The lowest risk of LGA/SGA was associated with a maternal p-BMI of 19.46 kg/m2. For pregnant women with maternal p-BMI below 24 kg/m2, we confirmed an optimal GWG linear equation: opt GWG (kg) = -1.94 × p-BMI (kg/m²) + 51, which showed an excellent degree of fit. Women who were overweight and obese could not achieve the lowest risk of LGA/SGA despite controlling their GWG; hence, their BMI should be normalized before pregnancy. By merely using the pre-pregnancy BMI, this study has established the optimal GWG equation, with the goal of achieving the appropriate fetal gestational age. It is a practical measure to ensure desirable pregnancy outcomes and meet the health economics requirements.

Mobil Monitoring Doppler Ultrasound (MoMDUS) study: protocol for a prospective, observational study investigating the use of artificial intelligence and low-cost Doppler ultrasound for the automated quantification of hypertension, pre-eclampsia and fetal growth restriction in rural Guatemala

IntroductionUndetected high-risk conditions in pregnancy are a leading cause of perinatal mortality in low-income and middle-income countries. A key contributor to adverse perinatal outcomes in these settings is limited access...

Abstract MP30: The Role of CD20+ B cells in Mediating Hypertension in Preeclampsia during Pregnancy

Pre-eclampsia (PE), new-onset hypertension after the 20 th week of pregnancy alongside other organ dysfunction, endothelial dysfunction, and immune activation. We have previously shown that CD19+ B cell adoptive transfer causes a PE phenotype in athymic nude rats. CD19 is present on all B cells including plasma cells. CD20 is absent from plasma cells but is present on mature B2 and memory B cells. The objective of this study was to determine if CD20+ B cells, excluding plasma cells, cause maternal hypertension, fetal growth restriction, and endothelial dysfunction. Three hundred thousand placental CD20+ B Cells from normal pregnant (NP) or PE patients were isolated by magnetic separation and injected i.p. into nude athymic rats on gestational day (GD) 12. On GD18, carotid catheters were inserted. On GD19, mean arterial pressure (MAP) was measured and blood and tissues were collected. Preproendothelin (PPET) expression was quantified in kidney and placental tissues using RT-PCR. A student’s t-test was used for statistical analysis. Participants whose placental B cells were used in this study had similar age, pre-pregnancy BMI, and diastolic BP on admission. PE participants had elevated systolic BP at admission (135±4 vs 120±4 mmHg) and delivery (139±6 vs 124±3 mmHg) as well as diastolic BP at delivery (79±4 vs 68±2 mmHg). PE participants also had trending decreases in fetal weight (2621±323 vs 3202±102 g) and gestational age (36±1 vs 39±0 weeks) at delivery. MAP increased from 107±4 mmHg (n=8) in the NP recipient rats to 123±2 mmHg (n=8, p<0.01) in the PE recipient rats. Pup and placental weights were unchanged following adoptive transfer. Renal PPET expression increased by 2.595±0.61 fold (ΔΔct) in PE recipient rats (n=7, p<0.05) compared to NP recipient rats (n=7). Placental PPET expression was unchanged following adoptive transfer. CD20+ B cells from women with PE contribute to hypertension and endothelial dysfunction during pregnancy. This data supports the important role of B cells in the development of PE and improves our understanding of the population of B cells responsible for contribution to the disease.

Does decreased fetal growth estimation in the appropriate for gestational age range affect delivery outcomes?

To study the effect of decreased estimated fetal weight (EFW) percentiles in appropriate for gestational age fetuses. This retrospective cohort study included women who had second and third trimester ultrasound examinations. Delivery and neonatal outcomes of pregnancies with decreased EFW of ≥ 30 percentiles in EFW between ultrasound examinations (decreased growth group) and those without such a decrease (control group) were compared. Deliveries with EFW or birthweight below the 10th percentile were excluded. Among 1610 deliveries, 57 were in the decreased growth group and 1553 in the control group. Maternal characteristics did not differ between the groups except for higher rate of nulliparity in the decreased growth group. We found similar rates of Category II/III monitoring, cesarean deliveries due to non-reassuring fetal heart rate and adverse neonatal outcomes. Neonatal birthweight was lower in the decreased growth group as compared to controls. This study did not find association between the group of appropriate for gestational age fetuses with decreased growth, with adverse outcomes.

Correlation between morphometry of fetal foot and gestational age: a cadaver study

Objectives: This study was conducted on a collection of fetal cadavers to describe the relationship between gestational age and foot parameters specifically in the Turkish population. Methods: The study involved 83 fetal cadavers (45 males, 38 females) ranging from 13 to 40 weeks of gestation, without external anomalies or pathologies. Various foot parameters were measured, including foot width (FW), heel width (HW), foot length (FL), heel-metatarsophalangeal fold (HMF), bimalleolar width (BW), foot dorsum length (FDL), ankle-metatarsophalangeal fold (AMF), malleolus medialis height (MMH), malleolus lateralis height (MLH), and finger length (FiL). These parameters were measured using a digital caliper with a precision of 0.01 mm. The fetuses were grouped by gestational month, and morphometric measurements were taken. Results: A strong and positive correlation was found between all foot parameters and gestational age (months). All parameters increased consistently throughout the fetal period. No significant differences were observed based on gender or side comparisons for any of the parameters. Linear regression equations were developed to estimate gestational age using fetal foot parameters. These parameters explained 72% to 90% of the variation in gestational age. Conclusion: Fetal foot length and related foot parameters can reliably be used to estimate gestational age. Due to the simplicity of these measurements, fetal foot parameters can be utilized to estimate age for babies born outside a hospital setting without the need for specialist equipment. Additionally, for premature babies receiving treatment in neonatal units, foot measurements offer a practical and easily accessible method for age estimation.

Fetal development and growth of extensor tendons and their sheaths in the dorsal side of the wrist and hand: a histological study.

To understand considerable variations in number of adult extensor ten-dons at the dorsal side of the wrist and hand. We examined histological sections from 30 human fetuses of gestational age 7-39 weeks and crown-rump length 22-323 mm. At the carpal level, earlier or smaller fetuses showed a simpler configuration with fewer tendon slips, whereas later or larger fetuses had a greater number of tendon slips with considerable variations in number and topographical relationships. Tendon slips of the early extensor digitorum to the middle and ring fingers were always 1 or 2, but were seven or more at late term. A tendon of the extensor digitorum to the little fin-ger could not be distinguished from other tendons at the carpal bone level. At the meta-carpal bone level, however, it extended from the ring finger tendon toward two slips of the extensor digiti minimi tendon. At the distal carpal level at midterm and late term, in which the tendon sheath was lost, each of the extensor digitorum tendon slips further divided to provide a mediolateral linear cluster of thin bundles. This large number of tendon components joined and united together to provide a single tight tendon at the level of the metacarpophalangeal joints. The extensor pollicis longs tendon usually lost a membranous septation when it crossed the extensor carpi radialis brevis tendon. Tendon slips in the fourth and fifth canals of the sheath were most likely to reduce in number after birth depending on the mechanical demand.

Pre-delivery BMI and the Accuracy of Fetal Weight Estimation in Very Preterm Infants

ObjectivesTo examine the relation between maternal pre-delivery BMI and the accuracy of sonographic estimated fetal weight (EFW) in very preterm infants (<32 weeks gestation). MethodsThis retrospective study included singleton infants born between January 2010 and March 2023, at gestational ages 230 to 316 weeks, at a tertiary university-affiliated hospital. Absolute weight, percentage error, absolute percentage error, and overestimation and underestimation of EFW were compared between women with pre-delivery normal weight (BMI 18.5–24.99 kg/m2), overweight (BMI 25.0–29.99 kg/m2), and obesity (BMI >35.0 kg/m2). Multivariate linear regression analyses adjusted for potential confounders were performed to assess relations of maternal pre-conception and of pre-delivery BMI, with EFW accuracy. ResultsIncluded were 286 pregnancies. The absolute difference, percentage error, absolute percentage error, error within the 10% range, and underestimation or overestimation of EFW were similar between the groups. The multivariate linear regression analyses did not show significant associations of pre-conceptional BMI or of pre-delivery BMI with the percentage error. However, for small for gestational age compared to appropriate for gestational age fetuses, the percentage error was greater (8.9% vs. –0.6%, β = 0.35, P < 0.001) and the absolute percentage error was greater (11.0% vs. 6.7%, P < 0.001). Small for gestational age fetuses were at risk of fetal weight overestimation (percentage error exceeding 15%); OR 7.20 (95% CI 2.91–17.80). ConclusionsMaternal pre-delivery BMI was not found to be related to EFW accuracy in very preterm infants. Nevertheless, EFW should be interpreted carefully, as it may underdiagnose poor fetal growth in this population.

Can the neutrophil-to-lymphocyte ratio be used as an early marker of small fetuses for gestational age? A prospective study.

Small-for-gestational-age (SGA) fetuses are at increased risk of mortality and morbidity, and less than 30% will be detected by any ultrasound scan within 4 weeks before delivery. Our aim was to evaluate the relationship between neutrophil/lymphocyte ratio (NLR) in the first trimester of pregnancy and SGA fetuses. We performed a prospective study between June 2021 and August 2022, to evaluate the relationship between the neutrophil to lymphocyte ratio in maternal blood in the first trimester of pregnancy, with the birth of an SGA fetus. One hundred ninety-four participants with singleton pregnancies between 11 + 1 and 13 + 6 weeks of gestation were recruited. Pregnancies affected with diagnosed fetal chromosomal abnormalities, or chronic pathologies were excluded. SGA was defined as birthweight less than the 10th centile (N = 42) and severe SGA as birthweight less than the 3rd centile for gestation (N = 10) according to a locally derived descriptive charts. The NLR value measured in the first trimester was compared between these two groups and controls. We found no statistically significant difference in NLR, (3.5 +/-1.2 vs. 3.4+/-1.2, p-value of 0.78) when comparing the SGA less than the 10th centile group to the control group. NLR was also not different between severe SGA and controls (3.6+/-1.4 vs. 3.4+/-1.2 p-value of 0.78). We found no association between first-trimester NLR ratio and SGA.

Evaluation of Chondral Defect Repair Using Human Fibronectin Adhesion Assay-Derived Chondroprogenitors Suspended in Lyophilized Fetal Collagen Scaffold: An Ex Vivo Osteochondral Unit Model Study.

Chondral defect repair is challenging due to a scarcity of reparative cells and the need to fill a large surface area, compounded by the absence of self-healing mechanisms. Fibronectin adhesion assay-derived chondroprogenitors (FAA-CPs) have emerged as a promising alternative with enhanced chondrogenic ability and reduced hypertrophy. De-cellularized bio-scaffolds are reported to act as extracellular matrix, mimicking the structural and functional characteristics of native tissue, thereby facilitating cell attachment and differentiation. This study primarily assessed the synergistic effect of FAA-CPs suspended in fetal cartilage-derived collagen-containing scaffolds in repairing chondral defects. The de-cellularized and lyophilized fetal collagen was prepared from the tibio-femoral joint of a 36 + 4-week gestational age fetus. FAA-CPs were isolated from osteoarthritic cartilage samples (n = 3) and characterized. In ex vivo analysis, FAA-CPs at a density of 1 × 106 cells were suspended in the lyophilized scaffold and placed into the chondral defects created in the Osteochondral Units and harvested on the 35th day for histological examination. The lyophilized scaffold of de-cellularized fetal cartilage with FAA-CPs demonstrated effective healing of the critical size chondral defect. This was evidenced by a uniform distribution of cells, a well-organized collagen-fibrillar network, complete filling of the defect with alignment to the surface, and favorable integration with the adjacent cartilage. However, these effects were less pronounced in the plain scaffold control group and no demonstrable repair observed in the empty defect group. This study suggests the synergistic potential of FAA-CPs and collagen scaffold for chondral repair which needs to be further explored for clinical therapy. The online version contains supplementary material available at 10.1007/s43465-024-01192-6.

Correlation of global cardiac sphericity index and neonatal outcomes of appropriate for gestational age foetuses, small for gestational age foetuses and growth restricted foetuses delivered at term in Dr. Jose Fabella memorial hospital: a prospective cohort study

Correlation of global cardiac sphericity index and neonatal outcomes of appropriate for gestational age foetuses, small for gestational age foetuses and growth restricted foetuses delivered at term in Dr. Jose Fabella memorial hospital: a prospective cohort study

Correlation of Gestational Age with Anterior-Posterior Thigh Diameter Measured by Two-Dimensional Sonography

Background: Anterior-posterior thigh diameter measurement via two-dimensional sonography (2D-US) correlates with fetal gestational age and reflects the growth and development of fetal thigh muscles and bones. This measurement, alongside estimated gestational age, offers valuable insights into fetal well-being and growth during pregnancy. This study aimed to evaluate the correlation of gestational age with anterior-posterior thigh diameter measured by two-dimensional sonography and estimated gestational age. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Mymensingh Medical College &amp; Hospital, Mymensingh, Bangladesh from January 2010 to January 2012. As the study subjects, a total of 250 healthy women between the 24th and 38th weeks of normal pregnancy were enrolled by using a purposive sampling technique. For data analysis, SPSS version 23.0 was used. Results: The mean age of the participants was 24.79 ± 4.71 years with a range from 18 to 35 years. More than one-third (34.0%) of the women were in the age range of 21-25 years. The mean gestational age of all participants was 30.93 ± 4.32 weeks. Primigravida accounted for more than half (56.4%) of them. A statistically significant positive correlation was observed between fetal anterior-posterior thigh diameter and gestational age (p&lt;0.001. Conclusion: There is a statistically significant positive correlation between fetal anterior-posterior thigh diameter and gestational age.

Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses.

To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses. Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1-5.1 and 5.2-10). Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476). Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.

Correlation of Estimated Gestational Age with the Anterior-Posterior Thigh Diameter and Other Parameters of Fetal Biometry

Background: Accurate gestational age estimation is vital for tracking pregnancy, identifying growth issues, and guiding clinical decisions. Including anterior-posterior thigh diameter (APTD) in fetal biometry enhances fetal health assessment. Correlating EGA with APTD and other biometry parameters is crucial for evaluating fetal growth and development. This study aimed to evaluate the correlation of estimated gestational age with the anterior-posterior thigh diameter and other parameters of fetal biometry. Methods: This cross-sectional study was conducted at the Department of Radiology and Imaging, Mymensingh Medical College &amp; Hospital, Mymensingh, Bangladesh, from January 2010 to January 2012. A total of 250 healthy women between the 24th and 38th weeks of normal pregnancy were enrolled using a purposive sampling technique. Data analysis was performed using SPSS version 23.0. Results: More than one-third (34.0%) of participants were aged 21-25 years. The mean gestational age was 30.93 ± 4.32 weeks, and over half (56.4%) were primigravida. Significant positive correlations were found between fetal anterior-posterior thigh diameter and gestational age (r=1.0; p&lt;0.001), bi-parietal diameter (r=0.856; p&lt;0.001), head circumference (r=0.962; p&lt;0.001), abdominal circumference (r=0.972; p&lt;0.001), and femur length (r=0.948; p&lt;0.001). Conclusion: The fetal anterior-posterior thigh diameter shows significant positive correlations with several parameters, including gestational age, biparietal diameter, head circumference, abdominal circumference, and femur length in this study.

&lt;i&gt;IGF1R&lt;/i&gt; rs907806 and &lt;i&gt;GHSR&lt;/i&gt; rs572169 genetic variants in fetal macrosomia

BACKGROUND: Being strongly affected by maternal and fetal genetic factors, intrauterine environment plays a critical role in fetal growth. Intrauterine conditions, in turn, are largely determined by the genetic factors. AIM: The aim of this study was to evaluate the effect of the IGF1R rs907806 and GHSR rs572169 genetic variants on the weight of newborns. MATERIALS AND METHODS: This prospective study included 221 mother-newborn pairs. The inclusion criteria were singleton pregnancy and informed consent to participate in the study. The exclusion criteria were severe somatic, oncological and acute illnesses three months prior or during pregnancy, gestational diabetes mellitus, refusal to participate in the study at any stage, and insufficient data. The study groups included patients with type 1 diabetes mellitus (group I), type 2 diabetes mellitus (group II), and no carbohydrate metabolism disorders (group III). Cord blood samples were obtained after delivery. The IGF1R rs907806 and GHSR rs572169 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism analysis. The main outcomes were delivery of a large for gestational age fetus (weight of more than the 90th percentile INTERGROWTH-21st). The secondary outcomes were diabetic fetopathy, diabetic cardiomyopathy, and neonatal hypoglycemia. RESULTS: In group III, the minor G allele of the IGF1R rs907806 variant was more frequent in large-for-gestational-age newborns (p = 0.017; odds ratio 3.039; 95% confidence interval 1.244–7.424) than in those with a weight of less than 90th percentile. For the GHSR rs572169 variant, no similar trend was observed. This pattern was pronounced in the male newborns only (rs907806 AA vs. AG+GG; p = 0.046; odds ratio 4.229, 95% confidence interval 1.181–15.139). In newborns with hypoglycemia, a higher frequency of the GG genotype of the GHSR rs572169 (GA) variant was observed in the total sample (p = 0.004) and the type 1 diabetes mellitus group (p = 0.0496). CONCLUSIONS: The IGF1R rs907806 variant may affect birthweight in the male newborns of mothers without carbohydrate metabolism disorders. The observed association of neonatal hypoglycemia with the GG genotype of the GHSR rs572169 variant requires further investigation. Genetic factors can contribute to prognostic models of perinatal complications, while improving their early diagnosis opportunities.

Fetal Gestational Age Prediction in Brain Magnetic Resonance Imaging Using Artificial Intelligence: A Comparative Study of Three Biometric Techniques

Accurately predicting a fetus’s gestational age (GA) is crucial in prenatal care. This study aimed to develop an artificial intelligence (AI) model to predict GA using biometric measurements from fetal brain magnetic resonance imaging (MRI). We assessed the significance of using different reference standards for interpreting GA predictions. Measurements of biparietal diameter (BPD), fronto-occipital diameter (FOD), and head circumference (HC) were obtained from 52 normal fetal MRI cases from Rush University. Both manual and AI-based methods were utilized, and comparisons were made using three reference standards (Garel, Freq, and Bio). The AI model showed a strong correlation with manual measurements, particularly for HC, which exhibited the highest correlation with actual values. Differences between GA predictions and picture archiving and communication system (PACS) records varied by reference, ranging from 0.47 to 2.17 weeks for BPD, 0.46 to 2.26 weeks for FOD, and 0.75 to 1.74 weeks for HC. Pearson correlation coefficients between PACS records and GA predictions exceeded 0.97 across all references. In conclusion, the AI model demonstrated high accuracy in predicting GA from fetal brain MRI measurements. This approach offers improved accuracy and convenience over manual methods, highlighting the potential of AI in enhancing prenatal care through precise GA estimation.

Placental biophysical model for prediction of early onset fetal growth restriction in first and second trimester of pregnancy: A prospective cohort study

IntroductionTo assess the placental biometry, placental biomarkers and uterine artery Doppler in each trimester of pregnancy for prediction of early-onset fetal growth restriction (EO FGR). MethodsIn this prospective cohort study placental biometry; biomarkers PAPP-A, sFLT-1, and PlGF along with the uterine artery blood flow evaluation was done serially at 11–14, 20–24 and 28–32 weeks of gestation. The above parameters were compared between women with early onset FGR and controls. ResultsOut of 1008 fully followed cases, the small for gestational age fetuses were 227/1008 (22.5 %), and EO FGR were 84/1008(8.3 %).The placental length, volume, and PlGF levels were significantly lower, whereas the uterine artery PI(Ut PI) was significantly higher at all time points among cases. The sFLT-1 level showed a significant increase among cases, whereas it decreased among controls from the first to the second trimester. The detection rate using PV/UtA PI was 60 % in the first trimester and 66.7 % in the second trimester at 30 % FPR. ConclusionThe PV/Ut PI in first and the second trimester was a good marker for the prediction of pregnancies at increased risk of developing EO FGR.