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Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth.
Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored.
Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not very preterm births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower odds for both overall and spontaneous preterm birth.
Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased odds of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the likelihood for preterm birth.
Keywords
fetal growth, preterm birth, ultrasound, early pregnancy, induction of labor
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1Elenisetal.JPG
Figure S1. Directed acyclic graph (DAG) showing the relation between covariates included in the analyses and exposure (accelerated early fetal growth) and outcome (preterm birth).
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CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
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Submission checks complete
On 28 Nov, 2020
Editorial decision: Accept
On 23 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 20 Nov, 2020
Editor assigned
On 19 Nov, 2020
Editor invited
On 19 Nov, 2020
Submission checks complete
On 19 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 04 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 01 Nov, 2020
Editor invited
On 01 Nov, 2020
Version 2
Posted 20 Oct, 2020
No comments provided
Editorial decision: Major revision
On 17 Oct, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
No comments provided
Editorial decision: Major revision
On 09 Aug, 2020
Review #2 received
Received 08 Aug, 2020
Reviewer #3 agreed
On 31 Jul, 2020
Review #1 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 28 Jul, 2020
Reviewer #2 agreed
On 28 Jul, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 25 Jun, 2020
First submitted
On 24 Jun, 2020
Submission checks complete
On 24 Jun, 2020
Editor invited
On 24 Jun, 2020
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Submission checks complete
On 28 Nov, 2020
Editorial decision: Accept
On 23 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 20 Nov, 2020
Editor assigned
On 19 Nov, 2020
Editor invited
On 19 Nov, 2020
Submission checks complete
On 19 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 04 Nov, 2020
Editor assigned
On 01 Nov, 2020
Submission checks complete
On 01 Nov, 2020
Editor invited
On 01 Nov, 2020
Version 2
Posted 20 Oct, 2020
No comments provided
Editorial decision: Major revision
On 17 Oct, 2020
Editor assigned
On 12 Oct, 2020
Submission checks complete
On 11 Oct, 2020
Editor invited
On 11 Oct, 2020
No comments provided
Editorial decision: Major revision
On 09 Aug, 2020
Review #2 received
Received 08 Aug, 2020
Reviewer #3 agreed
On 31 Jul, 2020
Review #1 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 28 Jul, 2020
Reviewer #2 agreed
On 28 Jul, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 25 Jun, 2020
First submitted
On 24 Jun, 2020
Submission checks complete
On 24 Jun, 2020
Editor invited
On 24 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth.
Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored.
Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not very preterm births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower odds for both overall and spontaneous preterm birth.
Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased odds of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the likelihood for preterm birth.
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1Elenisetal.JPG
Figure S1. Directed acyclic graph (DAG) showing the relation between covariates included in the analyses and exposure (accelerated early fetal growth) and outcome (preterm birth).
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