Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth

Authors

  • Michelle Lampl,

    Corresponding author
    1. Department of Anthropology, Emory University, Atlanta, Georgia
    2. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    3. Predictive Health Center for Health Discovery, Emory University, Atlanta, Georgia
    • Department of Anthropology, Emory University, Atlanta, Georgia
    Search for more papers by this author
  • Juan Pedro Kusanovic,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    2. Department of Obstetrics and Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, Michigan
    Search for more papers by this author
  • Offer Erez,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    2. Department of Obstetrics and Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, Michigan
    Search for more papers by this author
  • Francesca Gotsch,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    Search for more papers by this author
  • Jimmy Espinoza,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    Search for more papers by this author
  • Luis Goncalves,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    Search for more papers by this author
  • Wesley Lee,

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    Search for more papers by this author
  • Ricardo Gomez,

    1. Center for Perinatal Diagnosis and Research (CEDIP), Sotero del Rio Hospital, P. Universidad Catolica de Chile, Puente Alto, Chile
    Search for more papers by this author
  • Jyh Kae Nien,

    1. Center for Perinatal Diagnosis and Research (CEDIP), Sotero del Rio Hospital, P. Universidad Catolica de Chile, Puente Alto, Chile
    Search for more papers by this author
  • Edward A. Frongillo,

    1. Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
    Search for more papers by this author
  • Roberto Romero

    1. Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Development/NIH/DHHS, Bethesda, Maryland
    2. Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan
    Search for more papers by this author

Abstract

The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies (n = 3,706) and those with an episode of preterm labor followed by term delivery (n = 184) were identical across the time intervals 16–22 weeks, 22–28 weeks, and 28–34 weeks in a multilevel mixed-effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor (P < 0.05), declined across midgestation (22–28 weeks, P < 0.05), and rebounded between 28 and 34 weeks (P = 0.06). This was associated with perturbations in abdominal circumference growth and proportionately larger biparietal diameter from 22 gestational weeks (P = 0.03), greater femur (P = 0.01), biparietal diameter (P = 0.001) and head circumference (P = 0.02) dimensions relative to abdominal circumference across midgestation (22–28 weeks), followed by proportionately smaller femur diaphyseal length (P = 0.02) and biparietal diameter (P = 0.03) subsequently. A distinctive rapid growth phenotype characterized fetal growth preceding an episode of preterm labor among this sample of term-delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre-dating the preterm labor episode. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc.

Ancillary