Assessing first trimester growth: the influence of ethnic background and maternal age
Identifieur interne : 001125 ( Main/Exploration ); précédent : 001124; suivant : 001126Assessing first trimester growth: the influence of ethnic background and maternal age
Auteurs : Cecilia Bottomley [Royaume-Uni] ; Anneleen Daemen [Belgique] ; Faizah Mukri [Royaume-Uni] ; Aris T. Papageorghiou [Royaume-Uni] ; Emma Kirk [Royaume-Uni] ; Anne Pexsters [Belgique] ; Bart De Moor [Belgique] ; Dirk Timmerman [Belgique] ; Tom Bourne [Royaume-Uni, Belgique]Source :
- Human Reproduction [ 0268-1161 ] ; 2009-02.
Abstract
BACKGROUND First trimester growth restriction may predict miscarriage or adverse outcome later in the pregnancy, but determinants of early growth are not well described. Our objective was to examine factors influencing fetal and gestational sac size in the first trimester. METHODS Prospective observational study of 1828 singleton pregnancies before 12 weeks gestation. Maternal characteristics (ethnicity, maternal age, obstetric history, abdominal pain and vaginal bleeding), crown rump length (CRL) and mean gestational sac diameter (MSD) were recorded. A stepwise linear mixed effects analysis was performed to determine factors influencing rate of change in CRL and MSD. RESULTS 1063 scans, in 464 women, were included. Rate of increase in CRL was higher in women of black ethnic origin (P = 0.0261) compared with white, and increased with advancing maternal age (P = 0.0046). Maternal age also influenced MSD: older women had gestational sacs which were 0.118 mm larger for each one year increase in maternal age (P = 0.0073). Bleeding, pain and prior obstetric history did not influence CRL or MSD. CONCLUSIONS Rate of increase in CRL was greater in fetuses of black versus white women and increased with advancing maternal age. As CRL is used to date pregnancies, and this influences further growth assessment, consideration should be given to the use of individualized growth charts which take account of maternal factors found to influence first trimester growth.
Url:
DOI: 10.1093/humrep/den389
Affiliations:
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Papageorghiou</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Early Pregnancy and Gynaecological Ultrasound Unit, Department of Obstetrics and Gynaecology, St George's, University of London, Third Floor, Lanesborough Wing, Cranmer Terrace, London SW17 0RE</wicri:regionArea><orgName type="university">Université de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's, University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Kirk, Emma" sort="Kirk, Emma" uniqKey="Kirk E" first="Emma" last="Kirk">Emma Kirk</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Imperial College London, The Hammersmith Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Pexsters, Anne" sort="Pexsters, Anne" uniqKey="Pexsters A" first="Anne" last="Pexsters">Anne Pexsters</name><affiliation wicri:level="1"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University Hospitals, KU Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="De Moor, Bart" sort="De Moor, Bart" uniqKey="De Moor B" first="Bart" last="De Moor">Bart De Moor</name><affiliation wicri:level="1"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Timmerman, Dirk" sort="Timmerman, Dirk" uniqKey="Timmerman D" first="Dirk" last="Timmerman">Dirk Timmerman</name><affiliation wicri:level="1"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University Hospitals, KU Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Bourne, Tom" sort="Bourne, Tom" uniqKey="Bourne T" first="Tom" last="Bourne">Tom Bourne</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Imperial College London, The Hammersmith Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University Hospitals, KU Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Human Reproduction</title><idno type="ISSN">0268-1161</idno><idno type="eISSN">1460-2350</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-02">2009-02</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="284">284</biblScope><biblScope unit="page" to="290">290</biblScope></imprint><idno type="ISSN">0268-1161</idno></series><idno type="istex">8E7DFA51958A8F4DF583DE6A7DE3CB9631412879</idno><idno type="DOI">10.1093/humrep/den389</idno><idno type="ArticleID">den389</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0268-1161</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">BACKGROUND First trimester growth restriction may predict miscarriage or adverse outcome later in the pregnancy, but determinants of early growth are not well described. Our objective was to examine factors influencing fetal and gestational sac size in the first trimester. METHODS Prospective observational study of 1828 singleton pregnancies before 12 weeks gestation. Maternal characteristics (ethnicity, maternal age, obstetric history, abdominal pain and vaginal bleeding), crown rump length (CRL) and mean gestational sac diameter (MSD) were recorded. A stepwise linear mixed effects analysis was performed to determine factors influencing rate of change in CRL and MSD. RESULTS 1063 scans, in 464 women, were included. Rate of increase in CRL was higher in women of black ethnic origin (P = 0.0261) compared with white, and increased with advancing maternal age (P = 0.0046). Maternal age also influenced MSD: older women had gestational sacs which were 0.118 mm larger for each one year increase in maternal age (P = 0.0073). Bleeding, pain and prior obstetric history did not influence CRL or MSD. CONCLUSIONS Rate of increase in CRL was greater in fetuses of black versus white women and increased with advancing maternal age. As CRL is used to date pregnancies, and this influences further growth assessment, consideration should be given to the use of individualized growth charts which take account of maternal factors found to influence first trimester growth.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Bottomley, Cecilia" sort="Bottomley, Cecilia" uniqKey="Bottomley C" first="Cecilia" last="Bottomley">Cecilia Bottomley</name></region><name sortKey="Bottomley, Cecilia" sort="Bottomley, Cecilia" uniqKey="Bottomley C" first="Cecilia" last="Bottomley">Cecilia Bottomley</name><name sortKey="Bourne, Tom" sort="Bourne, Tom" uniqKey="Bourne T" first="Tom" last="Bourne">Tom Bourne</name><name sortKey="Kirk, Emma" sort="Kirk, Emma" uniqKey="Kirk E" first="Emma" last="Kirk">Emma Kirk</name><name sortKey="Mukri, Faizah" sort="Mukri, Faizah" uniqKey="Mukri F" first="Faizah" last="Mukri">Faizah Mukri</name><name sortKey="Papageorghiou, Aris T" sort="Papageorghiou, Aris T" uniqKey="Papageorghiou A" first="Aris T." last="Papageorghiou">Aris T. Papageorghiou</name><name sortKey="Papageorghiou, Aris T" sort="Papageorghiou, Aris T" uniqKey="Papageorghiou A" first="Aris T." last="Papageorghiou">Aris T. Papageorghiou</name></country><country name="Belgique"><noRegion><name sortKey="Daemen, Anneleen" sort="Daemen, Anneleen" uniqKey="Daemen A" first="Anneleen" last="Daemen">Anneleen Daemen</name></noRegion><name sortKey="Bourne, Tom" sort="Bourne, Tom" uniqKey="Bourne T" first="Tom" last="Bourne">Tom Bourne</name><name sortKey="De Moor, Bart" sort="De Moor, Bart" uniqKey="De Moor B" first="Bart" last="De Moor">Bart De Moor</name><name sortKey="Pexsters, Anne" sort="Pexsters, Anne" uniqKey="Pexsters A" first="Anne" last="Pexsters">Anne Pexsters</name><name sortKey="Timmerman, Dirk" sort="Timmerman, Dirk" uniqKey="Timmerman D" first="Dirk" last="Timmerman">Dirk Timmerman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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