A model for foetal growth and diagnosis of intrauterine growth restriction



A model for foetal growth is developed and used to construct tools for diagnosis of intrauterine growth restriction. Foetal weight estimates are first transformed to normally distributed z-scores. The covariance structure over gestational ages is then estimated using a novel regression model. The diagnostic tools include individual growth curves with error bounds, probabilities to assess whether a foetus is small for its gestational age, and residual scores to determine whether current growth rates are unusual. The methods were developed sing data from 13593 ultrasound examinations involving 7888 oetal subjects. The model shows that median foetal growth elocity increases up to a gestational age of 35 weeks and then ecreases during the final weeks of pregnancy. When growth is xpressed as change in log weight, or equivalently as change oportional to current weight, the model reveals a constant celeration as gestational age increases from 14 to 42 weeks. Copyright © 2002 John Wiley & Sons, Ltd.