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Deter RL, Lee W, Yeo L, Erez O, Ramamurthy U, Naik M, Romero R. Individualized growth assessment: conceptual framework and practical implementation for the evaluation of fetal growth and neonatal growth outcome. Am J Obstet Gynecol 2018; 218:S656-S678. [PMID: 29422206 DOI: 10.1016/j.ajog.2017.12.210] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 01/23/2023]
Abstract
Fetal growth abnormalities can pose significant consequences on perinatal morbidity and mortality of nonanomalous fetuses. The most widely accepted definition of fetal growth restriction is an estimated fetal weight less than the 10th percentile for gestational age according to population-based criteria. However, these criteria do not account for the growth potential of an individual fetus, nor do they effectively separate constitutionally small fetuses from ones that are malnourished. Furthermore, conventional approaches typically evaluate estimated fetal weight at a single time point, rather than using serial scans, to evaluate growth. This article provides a conceptual framework for the individualized growth assessment of a fetus/neonate based on measuring second-trimester growth velocity of fetal size parameters to estimate growth potential. These estimates specify size models that generate individualized third-trimester size trajectories and predict birth characteristics. Comparisons of measured and predicted values are used to separate normally growing fetuses from those with growth abnormalities. This can be accomplished with individual anatomical parameters or sets of parameters. A practical and freely available software (Individualized Growth Assessment Program) has been developed to allow implementation of this approach for clinical and research purposes.
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Affiliation(s)
- Russell L Deter
- Department of Obstetrics and Gynecology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
| | - Wesley Lee
- Department of Obstetrics and Gynecology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI
| | - Lami Yeo
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Detroit Medical Center, Hutzel Women's Hospital, Wayne State University School of Medicine, Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
| | - Offer Erez
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI; Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer sheva, Israel
| | - Uma Ramamurthy
- Office of Research Informational Technology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Medha Naik
- Office of Research Informational Technology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Roberto Romero
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, and Detroit, MI; Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI
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Garcia-Flores J, Cruceyra M, Cañamares M, Garicano A, Nieto O, Lopez A, Dorronsoro I, Tamarit I, Sainz De La Cuesta R. Fetal limb soft tissue assessment for prediction of birth weight and umbilical cord blood analytes in gestational diabetes. Prenat Diagn 2015; 35:1187-96. [DOI: 10.1002/pd.4669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/11/2015] [Accepted: 08/05/2015] [Indexed: 01/10/2023]
Affiliation(s)
- Jose Garcia-Flores
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Mireia Cruceyra
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Marina Cañamares
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Ainhoa Garicano
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Olga Nieto
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Ana Lopez
- Clinical Analysis Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Izaskun Dorronsoro
- Neonatology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Ines Tamarit
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
| | - Ricardo Sainz De La Cuesta
- High-Risk Pregnancy Unit. Obstetrics and Gynecology Department; Hospital Universitario Quiron Madrid; Pozuelo de Alarcon Madrid Spain
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