Maternal health, prenatal care matter most for baby size

Oxford University researchers who looked at ultrasound and other data found that babies born to women in good health with good prenatal care were all relatively similar in size at birth, and they conclude that maternal health is the most important factor affecting infant growth within the womb, not race or ethnicity. "We can create a similar start for all by making sure mothers are well educated and nourished, by treating infection and by providing adequate antenatal care," said researcher Jose Villar. The study, published in The Lancet Diabetes & Endocrinology, supports the need for international standards for measuring fetal growth, according to this article.

It has previously been suggested that 'race' and 'ethnicity' are largely responsible for differences in the size of babies born in different populations and countries.

But a landmark study led by Oxford University researchers has shown that growth of babies in the womb and their size at birth, especially their length, are strikingly similar the world over - when babies are born to healthy, well-educated and well-nourished mothers.

The study involved almost 60,000 pregnancies in eight defined urban areas in India, China, Brazil, Italy, Kenya, Oman, the United States and Britain.

"Currently we are not all equal at birth. But we can be," said the lead author professor Jose Villar from University of Oxford in Britain.

"We can create a similar start for all by making sure mothers are well educated and nourished, by treating infection and by providing adequate antenatal care," he added.

"Do not say that women in some parts of the world have small children because they are predestined to do so. It is simply not true," Villar noted.

The researchers carried out ultrasound scans from early pregnancy to delivery to measure babies' bone growth in the womb, using identical methods in all countries and the same ultrasound machines.
They also measured the length and head circumference of all babies at birth.

If mothers' educational, health and nutritional status and care during pregnancy are equally good, babies will have equal chances of healthy growth in the womb and future good health.

The findings give credence to the chorus calling for international standards to evaluate fetal growth and newborn size.

Fetal growth and newborn size are currently evaluated in clinics around the world using at least 100 different growth charts.

http://www.business-standard.com/article/news-ians/mother-s-health-influences-baby-size-the-most-114070700317_1.html 

OBSTETRIC ULTRASOUND

Ultrasound scan is currently considered to be a safe, non-invasive, accurate and cost-effective investigation in the fetus. It has progressively become a valuable obstetric tool and plays an important role in the care of every pregnant woman.

The gestational sac can be visualized as early as four and a half weeks of gestation and the yolk sac at about five weeks. The embryo can be observed and measured by about five and a half weeks. 

Ultrasound can also very importantly confirm the site of the pregnancy is within the cavity of the uterus. Many structural abnormalities in the fetus can be reliably diagnosed by an ultrasound scan, and these can usually be made before 20 weeks. Doppler ultrasound is presently most widely employed in the detection of fetal cardiac pulsations and pulsations in the various fetal blood vessels.

3/4-D ultrasound can give us visual 3/4 dimensional image of the scan.

The transducer takes a series of images, thin slices, of the subject, and the computer processes these images and presents them as a 3/4 dimensional image. A good 3/4-D image is often very impressive to the parents.

There is no hard and fast rule as to the number of scans a woman should have during her pregnancy. A scan is ordered when an abnormality is suspected. Otherwise a scan is generally booked at about 7 weeks to confirm pregnancy, exclude ectopic or molar pregnancies, confirm cardiac pulsation and measure the crown-rump length for dating.

A second scan is performed at 18 to 20 weeks mainly to look for congenital malformations, when the fetus is large enough for an accurate survey of the fetal anatomy. Multiple pregnancies can be firmly diagnosed and dates and growth can also be assessed. Placental position is also determined. Further scans may be necessary if abnormalities are suspected and can be done at around 32 weeks or later to evaluate fetal size (to estimate the fetal weight) and assess fetal growth or to follow up on possible abnormalities seen at an earlier scan. Placental position is further verified. The most common reason for having more scans in the later part of pregnancy is fetal growth retardation. Doppler scans may also be necessary in that situation.

It has been over 40 years since ultrasound was first used on pregnant women. Unlike X-rays, ionizing irradiation is not present. Current evidence indicates that diagnostic ultrasound is safe for the unborn child.