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Fetal Growth: What Is New in the Clinical Research?

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (15 March 2022) | Viewed by 13452

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Special Issue Editor

Prof. Dr. Erich Cosmi

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Guest Editor

Department of Woman’s and Child’s Health, University of Padova, Padova, Italy
Interests: fetus; maternal fetal medicine; doppler; cardiovascular diseases; endometrosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will focus on an important topic for perinatologists, neonatologists, pediatricians, biologists and engineers.

Growth abnormalities (such as growth restriction and large for gestational age) during perinatal and postnatal life are a hot topic issue, since they are often linked to alterations of the uterine environment caused by placental insufficiency, maternal metabolic syndrome, and, in general, under- or overnutrition of the fetus. These fetal abnormalities account for the leading causes of perinatal morbidity and mortality. Moreover, under the hypothesis of the developmental origin of adult diseases, they bear consequences in later life, programming the infant’s physiology for a higher risk of noncommunicable diseases, cardiovascular adult diseases, and neurodevelopment delay.

There is increasing evidence of a link between intrauterine and perinatal alterations and adult diseases. Although the main focus to date has been the timing of delivery and follow-up, the study of the pathophysiology and of possible recovery is of paramount importance and needs the contributions of physicians from several fields, biologists, bioinformaticians and engineers.

This Special Issue will focus on several aspects of intrauterine growth abnormalities and their follow-up.

We are glad to welcome several papers on the following topics:

Intrauterine growth restriction;
The fetal consequences of diabetes and gestational diabetes;
Cardiovascular programming;
Neurodevelopmental delay;
Fetal and neonatal imaging and imaging biomarkers;
Omics studies in fetal–neonatal growth abnormalities;
Recovery strategies, therapies, and prevention;
Maternal dietary and lifestyle effects in IUGR and LGA.

Prof. Dr. Erich Cosmi
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

IUGR
Doppler
LGA
Omics

Published Papers (6 papers)

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Editorial

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4 pages, 180 KiB

Open AccessEditorial

Commentary on Special Issue “Fetal Growth: What Is New in the Clinical Research?”

by Erich Cosmi and Silvia Visentin

J. Clin. Med. 2022, 11(19), 5795; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195795 - 29 Sep 2022

Cited by 1 | Viewed by 905

Abstract

Fetal growth restriction (FGR) is a common complication of pregnancy (3–10%) and has been associated with a variety of adverse perinatal outcomes [...] Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

Research

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9 pages, 419 KiB

Open AccessArticle

Perinatal and Neonatal Outcomes in Fetal Growth Restriction and Small for Gestational Age

by Chiara Lubrano, Emanuela Taricco, Chiara Coco, Fiorenza Di Domenico, Chiara Mandò and Irene Cetin

J. Clin. Med. 2022, 11(10), 2729; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102729 - 12 May 2022

Cited by 9 | Viewed by 2288

Abstract

Alterations in intrauterine fetal growth increase the risk of adverse perinatal and neonatal outcomes. In this retrospective study, we analyzed data of 906 pregnancies collected in our maternal fetal medicine center, with different patterns of growth: 655 AGA (Appropriate for Gestational Age), 62 SGA (Small for Gestational Age: fetuses born with a weight less than 10° centile, not diagnosed before delivery), 189 FGR (Fetal Growth Restriction, classified in early and late according to gestational week at diagnosis). For each group, we compared maternal characteristics, gestational age at delivery, and perinatal and neonatal outcomes. Risk factors for fetal growth alterations were advanced age, being primiparous, and a lower pregestational BMI. FGR fetuses were born at earlier gestational ages (32 [IQR 29–38] early-FGR and 38 [IQR 36–39] late-FGR), with blood gas values comparable to the AGA group but worse neonatal outcomes related to prematurity. Unexpected SGA fetuses born by vaginal delivery, managed as AGA, were more hyperlactacidemic (4.4 [IQR 2.7–5.5]) and hypoxemic (−5.0 [IQR −7.1–2.8]) at birth than both AGA and FGR. However, neonatal outcomes (accesses and days of hospitalization in NICU) were better than FGR, likely due to gestational age and birthweight similar to AGA. Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

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13 pages, 963 KiB

Open AccessArticle

Effect of Vitamin D Supplementation on the Cerebral Placental Ratio in Pregnancy Complicated with Early Fetal Growth Restriction

by Karolina Jakubiec-Wisniewska, Hubert Huras and Magdalena Kolak

J. Clin. Med. 2022, 11(9), 2627; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11092627 - 07 May 2022

Cited by 4 | Viewed by 1722

Abstract

Fetal growth restriction (FGR) is a complication of pregnancy connected with increased risk of intrauterine fetal demise. To increase the diagnostic accuracy, the cerebral placental ratio (CPR) is used. Vitamin D may play a role in the regulation of vascular flow in the fetus. The aim is to assess the relationship between CPR and vitamin D supplementation in fetuses with early FGR. It is a prospective cohort study. Pregnant females were divided into groups with 2000 IU and <500 IU of vitamin D. Both groups were observed for 14 days; USG was performed three times with one-week intervals. EFW and CPR were measured. Absolute CPR values were initially observed to differ significantly (p = 0.0032). Measurements on the seventh day of observation indicated that CPR was significantly higher (p = 0.0455) in fetuses of patients receiving vitamin D at a dose of 2000 IU 1.75 (IQR: 1.47; 2.06) vs. <500 IU group 1.55 (IQR: 1.04; 1.52). Similarly, on day 14: (p < 0.0001)—2.39 (IQR: 1.82; 2.69) vs. 1.21 (IQR: 0.98; 1.52). Supplementation with vitamin D at a dose of 2000 IU may have an influence on the increase in the CPR in fetuses with early FGR. Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

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13 pages, 1677 KiB

Open AccessArticle

Differential Expression of Glucose Transporter Proteins GLUT-1, GLUT-3, GLUT-8 and GLUT-12 in the Placenta of Macrosomic, Small-for-Gestational-Age and Growth-Restricted Foetuses

by Paweł Jan Stanirowski, Dariusz Szukiewicz, Agata Majewska, Mateusz Wątroba, Michał Pyzlak, Dorota Bomba-Opoń and Mirosław Wielgoś

J. Clin. Med. 2021, 10(24), 5833; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10245833 - 13 Dec 2021

Cited by 10 | Viewed by 2798

Abstract

Placental transfer of glucose constitutes one of the major determinants of the intrauterine foetal growth. The objective of the present study was to evaluate the expression of glucose transporter proteins GLUT-1, GLUT-3, GLUT-8 and GLUT-12 in the placenta of macrosomic, small-for-gestational-age (SGA) and growth-restricted foetuses (FGR). A total of 70 placental tissue samples were collected from women who delivered macrosomic ≥4000 g (n = 26), SGA (n = 11), growth-restricted (n = 13) and healthy control neonates (n = 20). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected GLUT proteins. Immunohistochemical staining identified the presence of all glucose transporters in the placental tissue. Quantitative morphometric analysis performed for the vascular density-matched placental samples revealed a significant decrease in GLUT-1 and increase in GLUT-3 protein expression in pregnancies complicated by FGR as compared to other groups (p < 0.05). In addition, expression of GLUT-8 was significantly decreased among SGA foetuses (p < 0.05). No significant differences in GLUTs expression were observed in women delivering macrosomic neonates. In the SGA group foetal birth weight (FBW) was negatively correlated with GLUT-3 (rho = −0.59, p < 0.05) and positively with GLUT-12 (rho = 0.616, p < 0.05) placental expression. In addition, a positive correlation between FBW and GLUT-12 expression in the control group (rho = 0.536, p < 0.05) was noted. In placentas derived from FGR-complicated pregnancies the expression of two major glucose transporters GLUT-1 and GLUT-3 is altered. On the contrary, idiopathic foetal macrosomia is not associated with changes in the placental expression of GLUT-1, GLUT-3, GLUT-8 and GLUT-12 proteins. Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

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14 pages, 1912 KiB

Open AccessArticle

Perinatal Adverse Effects in Newborns with Estimated Loss of Weight Percentile between the Third Trimester Ultrasound and Delivery. The GROWIN Study

by María Sonsoles Galán Arévalo, Ignacio Mahillo-Fernández, Luis Mariano Esteban, Mercedes Andeyro-García, Roi Piñeiro Pérez, Miguel Saénz de Pipaón and Ricardo Savirón-Cornudella

J. Clin. Med. 2021, 10(20), 4643; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10204643 - 10 Oct 2021

Cited by 2 | Viewed by 1803

Abstract

Fetal growth restriction has been associated with an increased risk of adverse perinatal outcomes (APOs). We determined the importance of fetal growth detention (FGD) in late gestation for the occurrence of APOs in small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) newborns. For this purpose, we analyzed a retrospective cohort study of 1067 singleton pregnancies. The newborns with higher APOs were SGA non-FGD and SGA FGD in 40.9% and 31.5% of cases, respectively, and we found an association between SGA non-FGD and any APO (OR 2.61; 95% CI: 1.35–4.99; p = 0.004). We did not find an increased APO risk in AGA FGD newborns (OR: 1.13, 95% CI: 0.80, 1.59; p = 0.483), except for cesarean delivery for non-reassuring fetal status (NRFS) with a decrease in percentile cutoff greater than 40 (RR: 2.41, 95% CI: 1.11–5.21) and 50 (RR: 2.93, 95% CI: 1.14–7.54). Conclusions: Newborns with the highest probability of APOs are SGA non-FGDs. AGA FGD newborns do not have a higher incidence of APOs than AGA non-FGDs, although with falls in percentile cutoff over 40, they have an increased risk of cesarean section due to NRFS. Further studies are warranted to detect these newborns who would benefit from close surveillance in late gestation and at delivery. Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

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17 pages, 2273 KiB

Open AccessArticle

Prediction of Late-Onset Small for Gestational Age and Fetal Growth Restriction by Fetal Biometry at 35 Weeks and Impact of Ultrasound–Delivery Interval: Comparison of Six Fetal Growth Standards

by Ricardo Savirón-Cornudella, Luis Mariano Esteban, Rocío Aznar-Gimeno, Peña Dieste-Pérez, Faustino R. Pérez-López, Jose Manuel Campillos, Berta Castán-Larraz, Gerardo Sanz and Mauricio Tajada-Duaso

J. Clin. Med. 2021, 10(13), 2984; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10132984 - 03 Jul 2021

Cited by 4 | Viewed by 2546

Abstract

Small-for-gestational-age (SGA) infants have been associated with increased risk of adverse perinatal outcomes (APOs). In this work, we assess the predictive ability of the ultrasound-estimated percentile weight (EPW) at 35 weeks of gestational age to predict late-onset SGA and APOs, according to six growth standards, and whether the ultrasound–delivery interval influences the detection rate. To this purpose, we analyze a retrospective cohort study of 9585 singleton pregnancies. EPWs at 35 weeks were calculated to the customized Miguel Servet University Hospital (MSUH) and Figueras standards and the non-customized MSUH, Fetal Medicine Foundation (FMF), INTERGROWTH-21st, and WHO standards. As results of our analysis, for a 10% false positive rate, the detection rates for SGA ranged between 48.9% with the customized Figueras standard (AUC 0.82) and 60.8% with the non-customized FMF standard (AUC 0.87). Detection rates to predict SGA by ultrasound–delivery interval (1–6 weeks) show higher detection rates as intervals decrease. APOs detection rates ranged from 27.0% with FMF to 7.9% with the Figueras standard. In conclusion, the ability of EPW to predict SGA at 35 weeks is good for all standards, and slightly better for non-customized standards. The APO detection rate is significantly greater for non-customized standards. Full article

(This article belongs to the Special Issue Fetal Growth: What Is New in the Clinical Research?)

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