ADJUSTING FOR FETAL SEX IN INDIVIDUAL CHARTS TO ASSESS THE RISK OF INTRAUTERINE GROWTH RETARDATION
Introduction: The diagnosis of intrauterine growth restriction in pregnancy is an important consideration in antenatal care, particularly in low-risk women, but often goes unrecognised. There are now population-based, individualised charts for the assessment of antenatal growth.
Aim: To determine the effect of changing maternal and fetal characteristics on fetal birth weight in a population of pregnant women in Kazakhstan.
Materials and Methods: The design of our study was one-stage cross-sectional. Inclusion criteria were: presence of first-trimester ultrasound screening at 10 - 14 weeks, uncomplicated pregnancy, and singleton pregnancy. Exclusion criteria were: multiple pregnancies, breech presentation, malposition (transverse, oblique), fetal weight less than 2500 grams and more than 4000 grams, premature birth, hypertensive states, antenatal fetal death, congenital malformations, hydramnion, hypamnion, and extragenital pathology.
Results: A total of 3,886 cases of term pregnancies in the cephalic presentation, which ended with a live birth weight of 2,500 to 4,000 grams, were selected for this study. On average, the weight of male newborns was 3440.0 grams and was greater than that of female newborns (Me 3370.0 grams). And as a function of gestational age, fetal weight became heavier with each week (p < 0.001). There was also a difference in mean fetal birth weight and uterine fundus height at 37 to 42 weeks gestation depending on fetal sex (p = 0.042, p = 0.021, p = 0.011, p = 0.002, respectively). An increase in fetal weight of 40.79 grams is to be expected when parity is increased by 1 birth. By linear regression, it was found that with a history of one birth an increase in fetal weight of 62.05 grams could be expected, with a history of 2 births an increase in fetal weight of 105.92 grams could be expected and with 3 or more births an increase in fetal weight of 107.91 grams could be expected. We found that an increase in fetal weight of 79.98 grams should be expected in the 20 - 24-year-old group compared to women under 20 years of age. And in the 25 – 29-year-old group an increase in fetal weight of 97.63 grams should be expected, in the 30 - 34-year-old group an increase of 104.22 grams and in the over 35-year-old women an increase of 84.62 grams should be expected. An increase in fetal weight of 101.98 grams should be expected when gestational age is increased by 1 week. An increase in fetal weight of 54.14 grams (p < 0.001) should be expected in pregnancies with a male fetus.
Conclusions: Fetal sex affects fetal weight and height at birth and uterine floor height at 37 to 42 weeks' gestation.
Meruert G. Sharipova1, https://orcid.org/0000-0002-5009-7387
Gulyash A. Tanysheva1, https://orcid.org/0000-0001-9531-5950
Anar S. Kystaubayeva2, https://orcid.org/0000-0002-8712-3307
Aizhan T. Shakhanova1, http://orcid.org/0000-0001-8214-8575
Zhanylsyn A. Ryspayeva 1, https://orcid.org/0000-0003-1748-6548
Zarina K. Zhaksylykova1, https://orcid.org/0009-0007-4997-2184
Kuat D. Akimzhanov1, https://orcid.org/0000-0002-8608-0771
Dana K. Kozhakhmetova1, http://orcid.org/0000-0002-8367-1461
1 NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
2 Multi-profile city hospital No. 3 of Astana Akimat, Astana, Republic of Kazakhstan.
1. Министерство Здравоохранения Республики Казахстан. Уход за маловесными новорожденными. Клинический протокол диагностики и лечения. 2023. № 177. (https://diseases.medelement.com. Дата обращения 20.04.2023)
2. Министерство Здравоохранения Республики Казахстан. Дистоция плечиков (затруднение при рождении плечевого поясв). Клинический протокол диагностики и лечения. 2023. № 178. (https://diseases.medelement.com. Дата обращения 20.04.2023)
3. Nguyen M.T., Ouzounian J.G. Evaluation and Management of Fetal Macrosomia. // Obstetrics and gynecology clinics of North America. 2021. Vol. 48, № 2. P. 387–399.
4. Bonellie S. et al. Centile charts for birthweight for gestational age for Scottish singleton births. // BMC pregnancy and childbirth. 2008. Vol. 8. P. 5.
5. Barros F.C. et al. Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions. // BMC pregnancy and childbirth. 2010. Vol. 10 Suppl 1, № Suppl 1. P. S3.
6. Risnes K.R. et al. Birthweight and mortality in adulthood: a systematic review and meta-analysis. // International journal of epidemiology. 2011. Vol. 40, № 3. P. 647–661.
7. Gardosi J., Francis A. Controlled trial of fundal height measurement plotted on customised antenatal growth charts. // British journal of obstetrics and gynaecology. 1999. Vol. 106, № 4. P. 309–317.
8. Gardosi J. et al. Customized growth charts: rationale, validation and clinical benefits. // American journal of obstetrics and gynecology. Elsevier Inc., 2018. Vol. 218, № 2S. P. S609–S618.
9. Millogo T. et al. Factors associated with fresh stillbirths: A hospital-based, matched, case-control study in Burkina Faso // International Journal of Gynecology & Obstetrics. 2016. Vol. 135, № S1. P. S98–S102.
10. Figueras F., Gardosi J. Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management // American Journal of Obstetrics and Gynecology. Mosby, Inc., 2011. Vol. 204, № 4. P. 288–300.
11. Vayssière C. et al. Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. // European journal of obstetrics, gynecology, and reproductive biology. 2015. Vol. 193. P. 10–18.
12. Damhuis S.E., Ganzevoort W., Gordijn S.J. Abnormal Fetal Growth: Small for Gestational Age, Fetal Growth Restriction, Large for Gestational Age: Definitions and Epidemiology. // Obstetrics and gynecology clinics of North America. Elsevier Inc, 2021. Vol. 48, № 2. P. 267–279.
13. Tarca A.L. et al. A new customized fetal growth standard for African American women: the PRB/NICHD Detroit study // American Journal of Obstetrics and Gynecology. 2018. Vol. 218, № 2. P. S679-S691.e4.
14. Pritchard N.L. et al. Adjusting growth standards for fetal sex improves correlation of small babies with stillbirth and adverse perinatal outcomes: A state-wide population study. // PloS one. 2022. Vol. 17, № 10. P. e0274521.
15. Monier I. et al. Does the Presence of Risk Factors for Fetal Growth Restriction Increase the Probability of Antenatal Detection? A French National Study // Paediatric and Perinatal Epidemiology. 2016. Vol. 30, № 1. P. 46–55.
16. Kiserud T. et al. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight // PLOS Medicine / ed. Myers J.E. 2017. Vol. 14, № 1. P. e1002220.
References: [1-2]
1. Ministerstvo Zdravookhraneniya Respubliki Kazakhstan. Ukhod za malovesnymi novorozhdennymi. Klinicheskiy protokol diagnostiki i lecheniya [Ministry of Healthcare of the Republic of Kazakhstan Care of low birth weight newborns. Clinical protocol for diagnosis and treatment]. 2023. № 177. https://diseases.medelement.com. (Accessed: 04.20.2023)
2. Ministerstvo Zdravookhraneniya Respubliki Kazakhstan. Distotsiya plechikov (zatrudnenie pri rozhdenii plechevogo poyasv). Klinicheskiy protokol diagnostiki i lecheniya [Ministry of Healthcare of the Republic of Kazakhstan. Shoulder dystocia (difficulty at birth of the shoulder girdle. Clinical protocol for diagnosis and treatment]. 2023. № 178. https://diseases.medelement.com. (Accessed: 04.20.2023)
Number of Views: 68
Category of articles:
Original articles
Bibliography link
Sharipova М.G., Tanysheva G.A., Kystaubayeva A.S., Shakhanova A.T., Ryspayeva Zh.А., Zhaksylykova Z.K., Akimzhanov K.D., Kozhakhmetova D.K. Adjusting for fetal sex in individual charts to assess the risk of intrauterine growth retardation // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 4, pp. 92-100. doi 10.34689/SH.2023.25.4.011Related publications:
ANALYSIS OF CLINICAL AND DEMOGRAPHIC INDICATORS OF PATIENTS WITH PARKINSON'S DISEASE IN THE SOUTHERN REGION OF KAZAKHSTAN
A COMPARATIVE STUDY OF DRUG POLICY REGARDING ORPHAN DISEASES IN THE USA, THE EUROPEAN UNION, AND THE REPUBLIC OF KAZAKHSTAN
MUTATIONS IN CARDIAC ION CHANNEL GENES IN KAZAKHSTANI PATIENTS WITH LONG QT SYNDROME
GENETIC FEATURES OF CONGENITAL DYSFUNCTION OF THE ADRENAL CORTEX CAUSED BY 21-HYDROXYLASE DEFICIENCY IN PERSONS OF KAZAKH NATIONALITY
NON-MOTOR SYMPTOMS IN PARKINSON'S DISEASE USING THE EXAMPLE OF AKTOBE PATIENTS