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First-trimester fetal size, accelerated growth in utero, and child neurodevelopment in a cohort study

BMC medicine, 2024-04, Vol.22 (1), p.181-181 [Peer Reviewed Journal]

2024. The Author(s). ;COPYRIGHT 2024 BioMed Central Ltd. ;2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2024 ;ISSN: 1741-7015 ;EISSN: 1741-7015 ;DOI: 10.1186/s12916-024-03390-3 ;PMID: 38685041

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Title:
First-trimester fetal size, accelerated growth in utero, and child neurodevelopment in a cohort study
Author: Chen, Xinmei ; Liu, Hongxiu ; Li, Yuanyuan ; Zhang, Wenxin ; Zhou, Aifen ; Xia, Wei ; Xu, Shunqing
Subjects: Adult ; Age ; Analysis ; Body mass index ; Brain ; Child development ; Child Development - physiology ; Child neurodevelopment ; Child, Preschool ; Children ; Children & youth ; China ; Cohort Studies ; Cohort study ; Cohorts ; Confounding (Statistics) ; Crown-Rump Length ; Family income ; Female ; Fetal Development - physiology ; Fetus ; Fetuses ; First-trimester fetal size ; Gestational age ; Growth ; Growth patterns ; Growth rate ; Hospitals ; Humans ; Infants ; Intrauterine accelerated growth ; Male ; Menstruation ; Mental development ; Missing data ; Neurodevelopment ; Parent educational background ; Pregnancy ; Pregnancy Trimester, First ; Ultrasonic imaging ; Variables ; Womens health
Is Part Of: BMC medicine, 2024-04, Vol.22 (1), p.181-181
Description: Early pregnancy is a critical window for neural system programming; however, the association of first-trimester fetal size with children's neurodevelopment remains to be assessed. This study aimed to explore the association between first-trimester fetal size and children's neurodevelopment and to examine whether intrauterine accelerated growth could compensate for the detrimental effects of first-trimester restricted growth on childhood neurodevelopment. The participants were from a birth cohort enrolled from March 2014 to March 2019 in Wuhan, China. A total of 2058 fetuses with crown to rump length (CRL) (a proxy of first-trimester fetal size) measurements in the first trimester and neurodevelopmental assessment at age 2 years were included. We measured the first-trimester CRL and defined three fetal growth patterns based on the growth rate of estimated fetal weight from mid to late pregnancy. The neurodevelopment was assessed using the Bayley Scales of Infant Development of China Revision at 2 years. Each unit (a Z score) increase of first-trimester CRL was associated with increased scores in mental developmental index (MDI) (adjusted beta estimate = 1.19, (95% CI: 0.42, 1.95), P = 0.03) and psychomotor developmental index (PDI) (adjusted beta estimate = 1.36, (95% CI: 0.46, 2.26), P < 0.01) at age 2 years, respectively. No significant association was observed between fetal growth rate and PDI. For children with restricted first-trimester fetal size (the lowest tertile of first-trimester CRL), those with "intrauterine accelerated growth" pattern (higher growth rates) had significantly higher MDI (adjusted beta estimate = 6.14, (95% CI: 3.80, 8.49), P < 0.001) but indistinguishable PDI compared to those with "intrauterine faltering growth" pattern (lower growth rates). Main limitations of this study included potential misclassification of gestational age due to recall bias of the last menstrual period and residual confounding. The current study suggests that restricted first-trimester fetal size is associated with mental and psychomotor developmental delay in childhood. However, in children with restricted first-trimester fetal size, intrauterine accelerated growth was associated with improved mental development but had little effect on psychomotor development. Additional studies are needed to validate the results in diverse populations.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1741-7015
EISSN: 1741-7015
DOI: 10.1186/s12916-024-03390-3
PMID: 38685041
Source: DOAJ Directory of Open Access Journals
GFMER Free Medical Journals
MEDLINE
PubMed Central
Springer Nature OA/Free Journals
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central

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First-trimester fetal size, accelerated growth in utero, and child neurodevelopment in a cohort study

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