fetal growth
Fetal growth in the first trimester has far reaching implications
What happens to babies in the womb has implications way beyond birth. The first trimester seems particularly important, A link has been established between poor growth in the first trimester and adverse birth outcomes in 1631 pregnant women with reliable dates. They also recorded accelerated growth in infancy for these babies, who seemed to be “catching up” growth they had missed in the first trimester. Rapid growth in infancy is a well known risk factor for cardiovascular dis¬ease in adults. A poor intrauterine environment in early pregnancy may have lifelong implica-tions, say the researchers.
They used crown-rump length between the 10th and 13th week of pregnancy as a proxy for early fetal growth. Smoking and failing to take folic acid supplements were both inde¬pendently associated with shorter crown-rump length in the first trimester. So were increases in diastolic blood pressure and maternal hae¬matocrit. After multiple adjustments, babies with a crown-rump length in the bottom fifth had more than twice the odds of being born preterm, at low birth weight , or small for gestational age compared with other babies.
lAMA 2010;303:527-34
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