Araştırma Makalesi
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Relationship between first trimester fetal crown-rump length and birth weight

Yıl 2018, Cilt: 2 Sayı: 1, 40 - 50, 11.02.2018

Öz

Objective: We aimed to investigate the relationship between the difference between
the expected and detected Crown-Rump Length (CRL) values ​​at the 11th
to 14th weeks of the gestation and the birth weight of the newborn.

Material and Method: Our study was performed retrospectively with 1361 pregnancies who
applied to our hospital for the first trimester screening test between 2013 and
2016 at their 11th to 14th gestational weeks. Patients
were studied in three groups according to the difference between the expected
and the determined CRL size. Group A (n: 266) was conducted if the CRL was
smaller than expected (difference between expected and detected CRL size is 2
to 6 days), Group B (n: 695) was conducted if the CRL was normal (difference is
1 day less, equal or more than 1 day), Group C (n: 400) was conducted if the
CRL was bigger than expected (the difference is 2-6 days less). The difference
between the detected CRL values and the abnormal birth weight relation was
assessed.

Results: The birth weight of the newborn was detected statistically difference
between only two groups (between Group A and C, between Group B and C).
According to this, the birth weight of Group C cases (3534,57 ± 461,76 g) was
statistically higher than Group A (3271,37 ± 486,94 g) (p = 0.0001). The birth
weight of Group C cases (3534,57 ± 461,76 g) was significantly higher than
Group B (3307,56 ± 352,51 g) (p = 0.0001). There were statistically significant
LGA fetuses in Group C (p = 0.0001). The highest LGA ratio was found in Group C
(14.5%); and the lowest LGA rate in Group B (2.6%).







Conclusion: Detection of expected large or small values in CRL size during early
gestation period should be a warning signal in terms of abnormal birth weight
complications and these should be followed up more strictly by antenatal follow
up.

Kaynakça

  • 1- Gluckman PD, Liggins GC. Regulation of Fetal Growth. In: Beard RW, Nathanielsz PW, editors. Fetal Physiology and Medicine: The Basis of Perinatology. 2nd ed.New York: M. Dekker; 1984. p. 511-58.
  • 2- Smith GC. First trimester origins of fetal growth impairment. Semin Perinatol 2004;28(1):41-50.
  • 3- Smith GC, Smith MF, McNay MB, et al. First-trimester growth and the risk of low birth weight. N Engl J Med 1998;339:1817–22.
  • 4- Bukowski R, Smith GC, Malone FD, et al. Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study. Br Med J 2007;334:836.
  • 5- Leung T, Sahota DS, Chan LW, et al. Prediction of birth weight by fetal crown–rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester. Ultrasound Obstet Gynecol 2008;31:10–4.
  • 6- Pedersen N, Figueras F, Wojdemann K,et al. Early fetal size and growth as predictors of adverse outcome. Obstet Gynecol 2008;112:765–71.
  • 7- Olson IE, Groveman SA, Lawson ML, et al. New intrauterine growth curves based on United States data. Pediatrics 2010;125:e214-24.
  • 8- Buck G, Cookfair DL, Michalek AM, et al. Intrauterine growth retardation and risk of sudden infant death syndrome (SIDS). Am J Epidemiol 1989;129:874–84.
  • 9- Barker D, Martyn C. The maternal and fetal origins of cardiovascular disease. J Epidemiol Community Health 1992;46:8–11.
  • 10- Baschat AA. Fetal growth restriction – from observation to intervention. J Perinat Med 2010;38:239–46.
  • 11- Balcazar H, Haas J. Classification schemes of small-for-gestational age and type of intrauterine growth retardation and its implications to early neonatal mortality. Early Hum Dev 1990;24:219–30.
  • 12- Kurtoğlu S, Akın MA, Sarıcı D. İntrauterin büyüme: Prenatal ve postnatal değerlendirilmesi. Turk Aile Hek Derg 2011;15(3):91-100.
  • 13- Hadlock FP, Shah YP, Kanon DJ, et al. Fetal crown-rump length: reevaluation of relation to menstrual age (5–18 weeks) with highresolution real-time US. Radiology 1992;182:501–5.
  • 14- Lawrence EJ. Part 1: a matter of size: evaluating the growth restricted neonate. Adv Neonatal Care 2006;6:313–22.
  • 15- Miller HC, Hassanein K. Diagnosis of impaired fetal growth in newborn infants. Pediatrics 1971;48: 511-22.
  • 16- Türkmen M, Aydoğan F, İnan G, et al. Aydın’da zamanında ve prematüre doğan bebeklerin ağırlık, boy, baş çevresi ölçümleri ve ponderal indeksleri. ADÜ Tıp Fakültesi Dergisi 2000;1:17-22
  • 17- Jae-Yul Kang, Eun-Ju Park, Yun-Suk Yang, et al. Crown-Rump Length Measured in the Early First Trimester as a Predictor of Low Birth Weight. Yonsei Med J. 2013;54:1049–1052.
  • 18- Pardo J, Peled Y, Yogev Y, et al. Association of Crown-Rump Length at 11 to 14 Weeks’ Gestation and Risk of a Large-for-Gestational-Age NeonateJ Ultrasound Med 2010;29:1315–1319
  • 19- Thorsell M, Kaijser M, Almström H, et al. Large fetal size in early pregnancy associated with macrosomia. Ultrasound Obstet Gynecol 2010;35:390–394.
  • 20- Salomon LJ, Hourrier S, Fanchin R, et al. Is first trimester crown-rump length associated with birthweight? BJOG 2011;118:1223–1228.
  • 21- Ustunyurt E, Simsek H, Korkmaz B, et al. First-trimester crown-rump length affects birth size symmetrically J Matern Fetal Neonatal Med, 2015; 28(17): 2070–2073
  • 22- Vafaei H, Samsami A, Zolghadri J, et al. Correlation of first-trimester fetal crown-rump length with outcome of pregnancy and birth weight. Int J Gynaecol Obstet. 2012 Nov;119(2):141-4.
  • 23- Mook-Kanamori D, Steegers EA, Eilers PH, et al. Risk factors and outcomes associated with first-trimester fetal growth restriction. JAMA 2010;303:527–34.

Birinci trimester fetal baş popo mesafesi ile doğum ağırlığı arasındaki ilişki

Yıl 2018, Cilt: 2 Sayı: 1, 40 - 50, 11.02.2018

Öz

Amaç: Çalışmamızda
11-14. gebelik haftaları arasında beklenen ve saptanan BPM değerleri arasındaki
fark ile yenidoğanın doğum ağırlığı arasındaki ilişkiyi araştırmayı amaçladık.

Gereç ve Yöntem:
2013 - 2016 yılları arasında, 11-14. Gebelik haftasına sahip olup ilk trimester
tarama testi için başvuran 1361 gebe çalışmaya dahil edildi. Hastalar beklenen
ve saptanan BPM boyutu arasındaki farka göre üç grupta incelendi. Son adet
tarihine (SAT) göre hesaplanan gebelik haftası, BPM ölçümü ile saptanan gebelik
haftasından 2-6 gün fazla ise Grup A (n:266), SAT’a göre gebelik haftası BPM’ye
göre hesaplanan gebelik haftasından 1 gün az, eşit ya da 1 gün fazla ise Grup B
(n:695), SAT’a göre hesaplanan gebelik haftası BPM ölçümü ile saptanan gebelik
haftasından 2-6 gün az ise Grup C (n:400) olarak adlandırıldı. Saptanan BPM
değerleri arasındaki fark ile anormal doğum ağırlığı ilişkisi değerlendirildi.

Bulgular: Yenidoğanın doğum ağırlığının Grup
A ile C ve Grup B ile C arasında istatistiksel anlamda farklılık gösterdiği
tespit edildi. Buna göre Grup C olguların doğum ağırlığı (3534,57±461,76 g),
Grup A olgulardan (3271,37±486,94 g) istatistiksel olarak daha fazla idi (p
=0.0001). Grup C olguların doğum ağırlığı (3534,57±461,76 g) Grup B
olgularından (3307,56±352,51 g) istatistiksel anlamda daha fazla idi (p
=0.0001).
Grup C de Grup B’den (p=0.0001) ve Grup C de
Grup A dan istatistiksel anlamda daha fazla LGA bebek görüldü (p=0.014).







Sonuç:
Erken fetal büyüme döneminde BPM boyutunda beklenenden büyük ya da küçük
değerlerin saptanması makrozomi ve düşük doğum ağırlığının (LBW) öngörülmesi
açısından uyarıcı bir işaret olabilir ve bu gebeler daha sıkı antenatal takibe
alınmalıdır.

Kaynakça

  • 1- Gluckman PD, Liggins GC. Regulation of Fetal Growth. In: Beard RW, Nathanielsz PW, editors. Fetal Physiology and Medicine: The Basis of Perinatology. 2nd ed.New York: M. Dekker; 1984. p. 511-58.
  • 2- Smith GC. First trimester origins of fetal growth impairment. Semin Perinatol 2004;28(1):41-50.
  • 3- Smith GC, Smith MF, McNay MB, et al. First-trimester growth and the risk of low birth weight. N Engl J Med 1998;339:1817–22.
  • 4- Bukowski R, Smith GC, Malone FD, et al. Fetal growth in early pregnancy and risk of delivering low birth weight infant: prospective cohort study. Br Med J 2007;334:836.
  • 5- Leung T, Sahota DS, Chan LW, et al. Prediction of birth weight by fetal crown–rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester. Ultrasound Obstet Gynecol 2008;31:10–4.
  • 6- Pedersen N, Figueras F, Wojdemann K,et al. Early fetal size and growth as predictors of adverse outcome. Obstet Gynecol 2008;112:765–71.
  • 7- Olson IE, Groveman SA, Lawson ML, et al. New intrauterine growth curves based on United States data. Pediatrics 2010;125:e214-24.
  • 8- Buck G, Cookfair DL, Michalek AM, et al. Intrauterine growth retardation and risk of sudden infant death syndrome (SIDS). Am J Epidemiol 1989;129:874–84.
  • 9- Barker D, Martyn C. The maternal and fetal origins of cardiovascular disease. J Epidemiol Community Health 1992;46:8–11.
  • 10- Baschat AA. Fetal growth restriction – from observation to intervention. J Perinat Med 2010;38:239–46.
  • 11- Balcazar H, Haas J. Classification schemes of small-for-gestational age and type of intrauterine growth retardation and its implications to early neonatal mortality. Early Hum Dev 1990;24:219–30.
  • 12- Kurtoğlu S, Akın MA, Sarıcı D. İntrauterin büyüme: Prenatal ve postnatal değerlendirilmesi. Turk Aile Hek Derg 2011;15(3):91-100.
  • 13- Hadlock FP, Shah YP, Kanon DJ, et al. Fetal crown-rump length: reevaluation of relation to menstrual age (5–18 weeks) with highresolution real-time US. Radiology 1992;182:501–5.
  • 14- Lawrence EJ. Part 1: a matter of size: evaluating the growth restricted neonate. Adv Neonatal Care 2006;6:313–22.
  • 15- Miller HC, Hassanein K. Diagnosis of impaired fetal growth in newborn infants. Pediatrics 1971;48: 511-22.
  • 16- Türkmen M, Aydoğan F, İnan G, et al. Aydın’da zamanında ve prematüre doğan bebeklerin ağırlık, boy, baş çevresi ölçümleri ve ponderal indeksleri. ADÜ Tıp Fakültesi Dergisi 2000;1:17-22
  • 17- Jae-Yul Kang, Eun-Ju Park, Yun-Suk Yang, et al. Crown-Rump Length Measured in the Early First Trimester as a Predictor of Low Birth Weight. Yonsei Med J. 2013;54:1049–1052.
  • 18- Pardo J, Peled Y, Yogev Y, et al. Association of Crown-Rump Length at 11 to 14 Weeks’ Gestation and Risk of a Large-for-Gestational-Age NeonateJ Ultrasound Med 2010;29:1315–1319
  • 19- Thorsell M, Kaijser M, Almström H, et al. Large fetal size in early pregnancy associated with macrosomia. Ultrasound Obstet Gynecol 2010;35:390–394.
  • 20- Salomon LJ, Hourrier S, Fanchin R, et al. Is first trimester crown-rump length associated with birthweight? BJOG 2011;118:1223–1228.
  • 21- Ustunyurt E, Simsek H, Korkmaz B, et al. First-trimester crown-rump length affects birth size symmetrically J Matern Fetal Neonatal Med, 2015; 28(17): 2070–2073
  • 22- Vafaei H, Samsami A, Zolghadri J, et al. Correlation of first-trimester fetal crown-rump length with outcome of pregnancy and birth weight. Int J Gynaecol Obstet. 2012 Nov;119(2):141-4.
  • 23- Mook-Kanamori D, Steegers EA, Eilers PH, et al. Risk factors and outcomes associated with first-trimester fetal growth restriction. JAMA 2010;303:527–34.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Çiğdem Yayla Abide

Ebru Çöğendez

Pınar Kumru

Murat Keskin

Evrim Bostancı Ergen

Çetin Kılıççı

Yayımlanma Tarihi 11 Şubat 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 2 Sayı: 1

Kaynak Göster

APA Yayla Abide, Ç., Çöğendez, E., Kumru, P., Keskin, M., vd. (2018). Birinci trimester fetal baş popo mesafesi ile doğum ağırlığı arasındaki ilişki. Balıkesir Medical Journal, 2(1), 40-50.