Association of Hypercholanaemia and Preeclampsia With Intrauterine Growth Restriction: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Fuzhen Song ◽  
Yuanyuan Chen ◽  
Lei Chen ◽  
Huan Li ◽  
Weibin Wu
BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033675
Author(s):  
Satoshi Shinohara ◽  
Shuji Hirata ◽  
Kohta Suzuki

ObjectivesThis study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories.DesignRetrospective cohort study.SettingA single primary and tertiary medical centre in Japan.ParticipantsThis study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET).InterventionsDifferences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring.Primary outcome measureEstimated fetal weight (EFW) assessed by ultrasound examination.ResultsWe assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW.ConclusionsThis study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth.


2014 ◽  
Vol 34 (2) ◽  
pp. 223-230 ◽  
Author(s):  
M. López ◽  
M. Palacio ◽  
A. Goncé ◽  
S. Hernàndez ◽  
F. J. Barranco ◽  
...  

2017 ◽  
Vol 20 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Cameron Sklar ◽  
Maryna Yaskina ◽  
Sue Ross ◽  
Kentia Naud

Significant management decisions in triplet pregnancies are made based mainly on ultrasound measurements of fetal growth, although there is a paucity of data examining the accuracy of fetal weight measurements in these gestations. To evaluate accuracy of prenatal ultrasound to diagnose growth abnormalities (intrauterine growth restriction, severe growth discordance) in triplet pregnancies, a retrospective cohort study of 78 triplet pregnancies (234 fetuses) delivered at a single tertiary hospital from January 2004 to May 2015 was performed. Growth percentiles from the last ultrasound were derived from estimated fetal weight using Hadlock's formula for each triplet. Growth discordance was calculated for each triplet set using the formula {(estimated fetal weight largest triplet - estimated fetal weight smallest)/estimated fetal weight largest}. These estimations were compared to birth weights. Sensitivity of ultrasound to predict ≥1 growth restricted fetus in a triplet set was 55.6% [95% CI 35.3, 74.5]; specificity was 100% [95% CI 93.0, 100]; positive predictive value (PPV) 100% [95% CI 74.7, 100]; negative predictive value (NPV) 81.0% [95% CI 73.2, 85.7%]. Sensitivity of ultrasound to detect fetal growth discordance >25% in a triplet set was 80.0% [95% CI 44.4, 97.5], specificity 94.1% [95% CI 85.6, 98.4]; PPV 66.7% [95% CI 42.4, 84.5]; NPV 97.0% [95% CI 90.2, 99.1]. Prenatal ultrasound currently remains the most reliable tool to screen for growth anomalies in triplet pregnancies; however, it appears to have less than ideal sensitivity, missing a number of cases of intra-uterine growth restriction and significant growth discordance.


Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 522
Author(s):  
Anna Kajdy ◽  
Stepan Feduniw ◽  
Jan Modzelewski ◽  
Dorota Sys ◽  
Dagmara Filipecka-Tyczka ◽  
...  

(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.


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