Article Text

Which growth criteria better predict fetal programming?


Objective To test whether customised (ct) growth criteria are more reliable than standard (st) ones to predict intrauterine insult.

Patients 32 mothers and their singleton term neonates selected as small for gestational age (st-SGA=8) or appropriate for gestational age (st-AGA=24).

Main outcome measures Nitric oxide, high-sensitive C reactive protein (hs-CRP), uric acid, blood lipids and protein levels were analysed in maternal and cord blood.

Results Applying customised criteria yielded 16 ct-AGA, 13 ct-SGA and 3 ct-LGA (large for gestational age) babies. Both st-SGA and ct-SGA babies had higher nitric oxide and hs-CRP levels. Their mothers had lower albumin fractions. st-SGA babies also had higher triglyceride and cholesterol levels. ct-LGA babies and mothers had higher uric acid levels, and the mothers had higher triglyceride levels.

Conclusions Customised growth criteria better identify babies submitted to unfavourable intrauterine environments. The authors suggest that combined with maternal biochemistry, these growth criteria can be used to screen for adverse fetal programming.

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