Fetal Growth Restriction Prediction: How to Move beyond
The actual burden and future burden of the small-for-gestational-age (SGA) babies turn their screening in pregnancy a question of major concern for clinicians and policymakers. Half of stillbirths are due to growth restriction in utero, and possibly, a quarter of livebirths of low- and middle-income...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2019/1519048 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561121792360448 |
|---|---|
| author | Debora F. B. Leite Jose G. Cecatti |
| author_facet | Debora F. B. Leite Jose G. Cecatti |
| author_sort | Debora F. B. Leite |
| collection | DOAJ |
| description | The actual burden and future burden of the small-for-gestational-age (SGA) babies turn their screening in pregnancy a question of major concern for clinicians and policymakers. Half of stillbirths are due to growth restriction in utero, and possibly, a quarter of livebirths of low- and middle-income countries are SGA. Growing body of evidence shows their higher risk of adverse outcomes at any period of life, including increased rates of neurologic delay, noncommunicable chronic diseases (central obesity and metabolic syndrome), and mortality. Although there is no consensus regarding its definition, birthweight centile threshold, or follow-up, we believe birthweight <10th centile is the most suitable cutoff for clinical and epidemiological purposes. Maternal clinical factors have modest predictive accuracy; being born SGA appears to be of transgenerational heredity. Addition of ultrasound parameters improves prediction models, especially using estimated fetal weight and abdominal circumference in the 3rd trimester of pregnancy. Placental growth factor levels are decreased in SGA pregnancies, and it is the most promising biomarker in differentiating angiogenesis-related SGA from other causes. Unfortunately, however, only few societies recommend universal screening. SGA evaluation is the first step of a multidimensional approach, which includes adequate management and long-term follow-up of these newborns. Apart from only meliorating perinatal outcomes, we hypothesize SGA screening is a key for socioeconomic progress. |
| format | Article |
| id | doaj-art-fa02f0e30a8c4c13b1564f543d654740 |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-fa02f0e30a8c4c13b1564f543d6547402025-02-03T01:25:55ZengWileyThe Scientific World Journal2356-61401537-744X2019-01-01201910.1155/2019/15190481519048Fetal Growth Restriction Prediction: How to Move beyondDebora F. B. Leite0Jose G. Cecatti1Department of Obstetrics and Gynecology, University of Campinas, School of Medical Sciences, Campinas, Sao Paulo, BrazilDepartment of Obstetrics and Gynecology, University of Campinas, School of Medical Sciences, Campinas, Sao Paulo, BrazilThe actual burden and future burden of the small-for-gestational-age (SGA) babies turn their screening in pregnancy a question of major concern for clinicians and policymakers. Half of stillbirths are due to growth restriction in utero, and possibly, a quarter of livebirths of low- and middle-income countries are SGA. Growing body of evidence shows their higher risk of adverse outcomes at any period of life, including increased rates of neurologic delay, noncommunicable chronic diseases (central obesity and metabolic syndrome), and mortality. Although there is no consensus regarding its definition, birthweight centile threshold, or follow-up, we believe birthweight <10th centile is the most suitable cutoff for clinical and epidemiological purposes. Maternal clinical factors have modest predictive accuracy; being born SGA appears to be of transgenerational heredity. Addition of ultrasound parameters improves prediction models, especially using estimated fetal weight and abdominal circumference in the 3rd trimester of pregnancy. Placental growth factor levels are decreased in SGA pregnancies, and it is the most promising biomarker in differentiating angiogenesis-related SGA from other causes. Unfortunately, however, only few societies recommend universal screening. SGA evaluation is the first step of a multidimensional approach, which includes adequate management and long-term follow-up of these newborns. Apart from only meliorating perinatal outcomes, we hypothesize SGA screening is a key for socioeconomic progress.http://dx.doi.org/10.1155/2019/1519048 |
| spellingShingle | Debora F. B. Leite Jose G. Cecatti Fetal Growth Restriction Prediction: How to Move beyond The Scientific World Journal |
| title | Fetal Growth Restriction Prediction: How to Move beyond |
| title_full | Fetal Growth Restriction Prediction: How to Move beyond |
| title_fullStr | Fetal Growth Restriction Prediction: How to Move beyond |
| title_full_unstemmed | Fetal Growth Restriction Prediction: How to Move beyond |
| title_short | Fetal Growth Restriction Prediction: How to Move beyond |
| title_sort | fetal growth restriction prediction how to move beyond |
| url | http://dx.doi.org/10.1155/2019/1519048 |
| work_keys_str_mv | AT deborafbleite fetalgrowthrestrictionpredictionhowtomovebeyond AT josegcecatti fetalgrowthrestrictionpredictionhowtomovebeyond |