Optimal fetal growth: a misconception? - 31/08/15
, Torvid Kiserud, MD, PhD b, Gerard H.A. Visser, MD, PhD c, Peter Brocklehurst, MBChB, MSc d, Eric B. Schneider, MPhil, DPhil eAbstract |
Alterations in fetal growth trajectory, either in terms of individual organs or the fetal body, constitute part of a suite of adaptive responses that the fetus can make to a developmental challenge such as inadequate nutrition. Nonetheless, despite substantial changes in nutrition in many countries over recent centuries, mean birthweight has changed relatively little. Low birthweight is recognized as a risk factor for later noncommunicable disease, although the developmental origins of such risk are graded across the full range of fetal growth and birthweight. Many parental and environmental factors, some biological and some cultural, can influence fetal growth, and these should not be viewed as abnormal. We argue that the suggestion of establishing a universal standard for optimal fetal growth ignores the breadth of these normal fetal responses. It may influence practice adversely, through incorrect estimation of gestational age and unnecessary elective deliveries. It raises ethical as well as practical issues.
Le texte complet de cet article est disponible en PDF.Key words : fetal growth trajectory, inadequate nutrition, low birthweight
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| The authors report no conflict of interest. |
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| This commentary arose in part from discussions at a workshop, Beyond Birthweight, held at the University of Sussex on Oct. 24-25, 2014, supported by the Wellcome Trust, the Developmental Origins of Health and Disease Society, the Economic History Society, and the University of Sussex Centre for Global Health Policy. |
Vol 213 - N° 3
P. 332.e1-332.e4 - septembre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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