Apr 16, 2014
from 01:30 PM to 02:30 PM
|Contact Name||Abby Roberts Fisher|
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Establishing Standards for Optimal Fetal Growth: Study Designs and Practical Considerations
Characterizing trajectories of normal and abnormal fetal growth is important for monitoring pregnancy and determining appropriate interventions which will improve the chances of healthy pregnancy outcomes. However, defining normal and abnormal fetal growth in clinical practice and research has not been straightforward. Most clinical and epidemiologic studies have classified abnormal growth based on birth weight outcome, as small-for-gestational-age (SGA) or large-for-gestational-age (LGA) using cross-sectional birth weight references that inadequately reflect patterns of under- or overgrowth and normative or optimal growth in fetuses at preterm gestations. Defining abnormal fetal growth remains a pressing clinical challenge. Further, until recently there have been few studies that have established fetal growth charts and/or velocity in diverse populations. The NICHD Fetal Growth Study was a cohort project conducted at 12 U.S. sites that recently finished accruing subjects. The study was designed specifically: 1) to establish an ultrasound standard for normal singleton fetal growth (velocity) and size for gestational age in the U.S. population; 2) to improve estimation of abnormal fetal growth; and 3) to examine a number of factors, including nutrition, psychosocial characteristics, and gravid conditions, for their effect on fetal growth. An overview of defining normal and abnormal fetal growth, as well as the design and clinical implications of the NICHD Fetal Growth Study will be presented.