PubMed · 4799090
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R de Leeuw. 1973-09-01. [Dysmaturity].. https://pubmed.ncbi.nlm.nih.gov/4799090/
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BACKGROUND: Previous studies have demonstrated a correlation between first-trimester size and birth weight. It is not known, however, whether low birth weight is related to first-trimester growth. We sought to determine whether the risk of low birth weight and birth weight that was low for gestational age is related to the size of the embryo or the fetus in the first trimester. METHODS: From a data base of ultrasound records of more than 30,000 pregnancies, we identified women who had no important medical problems, a normal menstrual history, and a first-trimester ultrasound scan in which the crown-rump length of the embryo or fetus had been measured. We examined the relation between the outcome of 4229 pregnancies and the difference between the measured and the expected crown-rump length in the first trimester, expressed as equivalent days of growth. RESULTS: A first-trimester crown-rump length that was two to six days smaller than expected was associated with an increased risk (as compared with a normal or slightly larger than expected crown-rump length) of a birth weight below 2500 g (relative risk, 1.8; 95 percent confidence interval, 1.3 to 2.4), a birth weight below 2500 g at term (relative risk, 2.3; 95 percent confidence interval, 1.4 to 3.8), a birth weight below the fifth percentile for gestational age (relative risk, 3.0; 95 percent confidence interval, 2.0 to 4.4), and delivery between 24 and 32 weeks of gestation (relative risk, 2.1; 95 percent confidence interval, 1.1 to 4.0), but not with delivery between 33 and 36 weeks (relative risk, 1.0; 95 percent confidence interval, 0.7 to 1.5). CONCLUSIONS: Suboptimal first-trimester growth may be associated with low birth weight, low birth-weight percentile, and premature delivery.
The proportion of children with high birthweights is increasing in Sweden, as in the other Nordic countries. According to the Swedish national birth registry (founded in 1973), the proportion of term (i.e. (37 gestational weeks) offspring of singelton pregnancies, and weighing four kg or more, increased from 16.9 per cent in 1973 to 20.3 per cent in 1995. The respective figures for the first-born subgroup were 12.9 and 15 per cent, the increase in mean birthweight being from 3400 to 3520 g. There was a corresponding increase in head circumference. The risk of delivery-related complications increases with birthweight over four kg, and a higher incidence of major perineal rupture (grade 3 or 4) has been reported, as well as a disturbing increase in the incidence of brachial plexus damage. Findings in recent studies suggest high birthweight to be associated with an increased risk of subsequent morbidity, both in childhood and in adulthood, specifically diabetes type 1, eczema and certain malignancies, particularly breast cancer and prostate cancer. Although the cause of the increasing proportion of large newborns is not known, it may be partly due to weight increase among gravidae. Another possible explanation is reduced maternal smoking, as smoking is less common now than in the 1970s.
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