Background: The objective of this study was to evaluate the association between maternal characteristics in early pregnancy and fetal growth (FG) and birth weight (BW). Methods: A prospective cohort study was performed in unselected pregnant women who attended an ultrasound evaluation at 11-14 weeks of pregnancy. Medical history, biochemical blood tests, biophysical variables and fetal weight at 20-25 and 30-36 weeks as well as the BW were assessed. Bivariate and multivariate linear models were constructed. Results: In all, 543 patients with normal pregnancy and labor were selected. The multiple regression analysis showed a statistically significant association between maternal body mass index (BMI) in early pregnancy and the uterine artery pulsatility index (UtAPI) in the first trimester with BW (p < 0.0008) and with the ratio of fetal growth between the second and third trimesters (p < 0.0001). No correlation was found between these variables and first trimester levels of hemoglobin or glycemia. Conclusion: Maternal first trimester BMI and UtAPI correlate with the rate of intrauterine FG and with the BW. This evidence highlights the influence of maternal first trimester variables on fetuses with normal growth and the potential role of these variables in fetal programming.

1.
Godfrey KM, Barker DJ: Fetal programming and adult health. Public Health Nutr 2001;4:611-624.
2.
Barker DJ: In utero programming of chronic disease. Clin Sci (Lond) 1998;95:115-128.
3.
Barker DJ, Thornburg KL: The obstetric origins of health for a lifetime. Clin Obstet Gynecol 2013;56:511-519.
4.
Barker DJ, Thornburg KL: Placental programming of chronic diseases, cancer and lifespan: a review. Placenta 2013;34:841-845.
5.
Zhang J, Merialdi M, Platt LD, Kramer MS: Defining normal and abnormal fetal growth: promises and challenges. Am J Obstet Gynecol 2010;202:522-528.
6.
Romo A, Carceller R, Tobajas J: Intrauterine growth retardation (IUGR): epidemiology and etiology. Pediatr Endocrinol Rev 2009;6(suppl 3):332-336.
7.
González RP, Gómez RM, Castro RS, et al: [A national birth weight distribution curve according to gestational age in Chile from 1993 to 2000]. Rev Med Chil 2004;132:1155-1165.
8.
Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK: Estimation of fetal weight with the use of head, body, and femur measurements - a prospective study. Am J Obstet Gynecol 1985;151:333-337.
9.
Dudley NJ: A systematic review of the ultrasound estimation of fetal weight. Ultrasound Obstet Gynecol 2005;25:80-89.
10.
Mayer C, Joseph KS: Fetal growth: a review of terms, concepts and issues relevant to obstetrics. Ultrasound Obstet Gynecol 2013;41:136-145.
11.
Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A: Maternal and fetal risk factors for stillbirth: population based study. BMJ 2013;346:f108.
12.
Hod M, Merlob P, Friedman S, Schoenfeld A, Ovadia J: Gestational diabetes mellitus. A survey of perinatal complications in the 1980s. Diabetes 1991;40(suppl 2):74-78.
13.
Lazebnik N, Many A: The severity of polyhydramnios, estimated fetal weight and preterm delivery are independent risk factors for the presence of congenital malformations. Gynecol Obstet Invest 1999;48:28-32.
14.
Metzger BE, Lowe LP, Dyer AR, et al: Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008;358:1991-2002.
15.
Dyer JS, Rosenfeld CR: Metabolic imprinting by prenatal, perinatal, and postnatal overnutrition: a review. Semin Reprod Med 2011;29:266-276.
16.
Walsh JM, McAuliffe FM: Prediction and prevention of the macrosomic fetus. Eur J Obstet Gynecol Reprod Biol 2012;162:125-130.
17.
Lynch J, Smith GD: A life course approach to chronic disease epidemiology. Annu Rev Public Health 2005;26:1-35.
18.
Correa PJ, Vargas JF, Sen S, Illanes SE: Prediction of gestational diabetes early in pregnancy: targeting the long-term complications. Gynecol Obstet Invest 2014;77:145-149.
19.
Ma N, Hardy DB: The fetal origins of the metabolic syndrome: can we intervene? J Pregnancy 2012;2012:482690.
20.
Boney CM, Verma A, Tucker R, Vohr BR: Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005;115:e290-e296.
21.
McCowan LM, Thompson JM, Taylor RS, et al: Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort. PLoS One 2013;8:e70917.
22.
Cnossen JS, Morris RK, ter Riet G, et al: Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 2008;178:701-711.
23.
Seravalli V, Block-Abraham DM, Turan OM, et al: First-trimester prediction of small-for-gestational age neonates incorporating fetal Doppler parameters and maternal characteristics. Am J Obstet Gynecol 2014;211:261.e1-e8.
24.
Velauthar L, Plana MN, Kalidindi M, et al: First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analysis involving 55,974 women. Ultrasound Obstet Gynecol 2014;43:500-507.
25.
Benavides-Serralde A, Hernandez-Andrade E, Fernandez-Lara A, et al: Accuracy of different equations for estimating fetal weight. Gynecol Obstet Invest 2011;72:264-268.
26.
Nicolaides K, Giuzeppe R, Hecher K, Ximenes R: Doppler in Obstetrics, 2002. http://fetalmedicine.org/var/uploads/Doppler-in-Obstetrics.pdf (accessed August 26, 2014).
27.
Segovia SA, Vickers MH, Gray C, Reynolds CM: Maternal obesity, inflammation, and developmental programming. Biomed Res Int 2014;2014:418975.
28.
Hrolfsdottir L, Rytter D, Olsen SF, et al: Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age. Int J Obes (Lond) 2015;39:671-676.
29.
Gaillard R, Steegers EA, Franco OH, Hofman A, Jaddoe VW: Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study. Int J Obes (Lond) 2015;39:677-685.
30.
Ghosh GS, Gudmundsson S: Uterine and umbilical artery Doppler are comparable in predicting perinatal outcome of growth-restricted fetuses. BJOG 2009;116:424-430.
31.
Cruz-Martinez R, Savchev S, Cruz-Lemini M, Mendez A, Gratacos E, Figueras F: Clinical utility of third-trimester uterine artery Doppler in the prediction of brain hemodynamic deterioration and adverse perinatal outcome in small-for-gestational-age fetuses. Ultrasound Obstet Gynecol 2015;45:273-278.
32.
Shamshirsaz AA, Paidas M, Krikun G: Preeclampsia, hypoxia, thrombosis, and inflammation. J Pregnancy 2012;2012:374047.
33.
Sánchez-Aranguren LC, Prada CE, Riaño-Medina CE, Lopez M: Endothelial dysfunction and preeclampsia: role of oxidative stress. Front Physiol 2014;5:372.
34.
Poon LC, Nicolaides KH: Early prediction of preeclampsia. Obstet Gynecol Int 2014;2014:297397.
35.
Dane B, Batmaz G, Ozkal F, Bakar Z, Dane C: Effect of parity on first-trimester uterine artery Doppler indices and their predictive value for pregnancy complications. Gynecol Obstet Invest 2014;77:24-28.
36.
Gomez-Roig MD, Mazarico E, Sabria J, Parra J, Oton L, Vela A: Use of placental growth factor and uterine artery Doppler pulsatility index in pregnancies involving intrauterine fetal growth restriction or preeclampsia to predict perinatal outcomes. Gynecol Obstet Invest 2015;80:99-105.
37.
Parra-Cordero M, Rodrigo R, Barja P, et al: Prediction of early and late pre-eclampsia from maternal characteristics, uterine artery Doppler and markers of vasculogenesis during first trimester of pregnancy. Ultrasound Obstet Gynecol 2013;41:538-544.
38.
Caradeux J, Serra R, Nien JK, et al: First trimester prediction of early onset preeclampsia using demographic, clinical, and sonographic data: a cohort study. Prenat Diagn 2013;33:732-736.
39.
Baschat AA, Gembruch U: The cerebroplacental Doppler ratio revisited. Ultrasound Obstet Gynecol 2003;21:124-127.
40.
Carbillon L: First trimester uterine artery Doppler for the prediction of preeclampsia and foetal growth restriction. J Matern Fetal Neonatal Med 2012;25:877-883.
41.
Figueras F, Gratacós E: Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther 2014;36:86-98.
42.
Figueras F, Gratacos E: Stage-based approach to the management of fetal growth restriction. Prenat Diagn 2014;34:655-659.
43.
Figueras F, Savchev S, Triunfo S, Crovetto F, Gratacos E: An integrated model with classification criteria to predict small-for-gestational-age fetuses at risk of adverse perinatal outcome. Ultrasound Obstet Gynecol 2015;45:279-285.
44.
Parra-Saavedra M, Crovetto F, Triunfo S, et al: Association of Doppler parameters with placental signs of underperfusion in late-onset small-for-gestational-age pregnancies. Ultrasound Obstet Gynecol 2014;44:330-337.
45.
Parra-Saavedra M, Simeone S, Triunfo S, et al: Correlation between histological signs of placental underperfusion and perinatal morbidity in late-onset small-for-gestational-age fetuses. Ultrasound Obstet Gynecol 2015;45:149-155.
46.
Parra-Saavedra M, Crovetto F, Triunfo S, et al: Placental findings in late-onset SGA births without Doppler signs of placental insufficiency. Placenta 2013;34:1136-1141.
47.
Figueras F, Cruz-Martinez R, Sanz-Cortes M, et al: Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing. Ultrasound Obstet Gynecol 2011;38:288-294.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.