L J Salomon1, S Hourrier, R Fanchin, Y Ville, P Rozenberg. 1. Department of Obstetrics and Gynecology, Paris Descartes University, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Société Française pour l'Amélioration des Pratiques Echographiques (SFAPE), Paris, France. laurentsalomon@gmail.com
Abstract
OBJECTIVE: To evaluate the relationship between first-trimester crown-rump length (CRL) and birthweight (BW) Z scores. DESIGN: Retrospective cohort study. SETTING: Two tertiary centres in France. POPULATION: Three hundred and seventeen pregnancies conceived through assisted reproductive techniques between April 2001 and December 2008. METHODS: We used CRL and worked forward to BW. Only pregnancies examined during the first trimester by an Fetal Medicine Foundation-certified operator were included. CRL was expressed as Z scores, and BW was transformed into Z scores by taking gestational age and gender into account. The influence of abnormal first-trimester CRL Z scores on BW was examined. MAIN OUTCOME MEASURES: Weight and gestational age at birth. RESULTS: Birth weight was significantly greater in babies with larger CRL: BW Z scores (± SD) were -0.36 (± 1.05), -0.27 (± 0.97), -0.10 (± 1.04) and 0.13 (± 0.96) in the first, second, third and fourth quartiles of CRL Z scores, respectively (P = 0.01). In contrast, there was no difference in gestational length according to the quartiles of the CRL Z scores. The CRL Z score was a significant predictor of the BW Z score (β = 0.17, P = 0.001). After adjustment for maternal body mass index, a one-point increase in the first-trimester CRL Z score (i.e. 3.6 mm) was associated with a 39% decrease, 64% increase, 114% increase and 62% increase in the risk of having a BW below the 10th centile [odds ratio (OR), 0.61; 95% confidence intervals (95% CI), 0.39; 0.95; P=0.03], above the 90th centile (OR, 1.64; 95% CI, 1.03; 2.60; P = 0.02), above the 95th centile (OR, 2.14; 95% CI, 1.25; 3.68; P = 0.006) and above 4000 g (OR, 1.62; 95% CI, 1.04; 2.51; P = 0.04), respectively. CONCLUSIONS: Variations in BW may be partly explained by differences in growth trajectories that may express as early as the first trimester.
OBJECTIVE: To evaluate the relationship between first-trimester crown-rump length (CRL) and birthweight (BW) Z scores. DESIGN: Retrospective cohort study. SETTING: Two tertiary centres in France. POPULATION: Three hundred and seventeen pregnancies conceived through assisted reproductive techniques between April 2001 and December 2008. METHODS: We used CRL and worked forward to BW. Only pregnancies examined during the first trimester by an Fetal Medicine Foundation-certified operator were included. CRL was expressed as Z scores, and BW was transformed into Z scores by taking gestational age and gender into account. The influence of abnormal first-trimester CRL Z scores on BW was examined. MAIN OUTCOME MEASURES: Weight and gestational age at birth. RESULTS: Birth weight was significantly greater in babies with larger CRL: BW Z scores (± SD) were -0.36 (± 1.05), -0.27 (± 0.97), -0.10 (± 1.04) and 0.13 (± 0.96) in the first, second, third and fourth quartiles of CRL Z scores, respectively (P = 0.01). In contrast, there was no difference in gestational length according to the quartiles of the CRL Z scores. The CRL Z score was a significant predictor of the BW Z score (β = 0.17, P = 0.001). After adjustment for maternal body mass index, a one-point increase in the first-trimester CRL Z score (i.e. 3.6 mm) was associated with a 39% decrease, 64% increase, 114% increase and 62% increase in the risk of having a BW below the 10th centile [odds ratio (OR), 0.61; 95% confidence intervals (95% CI), 0.39; 0.95; P=0.03], above the 90th centile (OR, 1.64; 95% CI, 1.03; 2.60; P = 0.02), above the 95th centile (OR, 2.14; 95% CI, 1.25; 3.68; P = 0.006) and above 4000 g (OR, 1.62; 95% CI, 1.04; 2.51; P = 0.04), respectively. CONCLUSIONS: Variations in BW may be partly explained by differences in growth trajectories that may express as early as the first trimester.
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