To explore whether prematurity as well as smallness for gestational age sga predisposes to precocious pubarche, and the potential role of excess weight gain during childhood. The ponderal index among iugr infants, but also among infants with a normal birth weight, is an independent predictor of neonatal morbidity. The day of delivery was used as the primary reference point for describing doppler changes figure 1. The consequences of in utero growth restriction have been attracting scholarly attention for the past two decades. Birth weight bwlength ratios, ponderal indexes, placental weights, and bwplacental weight ratios have been correlated with perinatal morbidity and mortality. Doc intrauterine growth restriction grays nathania. But in certain cases, babies in the womb are smaller than they should be.
Effect of birth weight on adulthood renal function. Pdf on jul 1, 2005, jabeen fayyaz and others published ponderal index find, read and cite all the research you need on researchgate. Intrauterine growth retardation diagnosed by rohrers ponderal. He has had different issues over the last few months mainly in regards to. The aim of this study is to evaluate such relationships in a population of newborns, along with other epidemiological and auxological parameters, in particular the ponderal index pi. Whether to deliver an extremely premature foetus suffering from iugr is a dilemma. Effects of iugr on the development of very low birthweight. The corpulence index ci or ponderal index pi is a measure of leanness corpulence of a person calculated as a relationship between mass and height. What is selective intrauterine growth restriction siugr. The relationship between maternal glomerular filtration rate. Small for gestational age sga refers to an infant whose birth weight was below the 10th percentile for the appropriate gestational age. The ponderal index and the machc ratio provide information on the proportionality of body growth.
The main difference between the pi and bmi equation is. Fetal growth restriction vanderbilt university medical. The use and interpretation of ponderal index and other weight. The ponderal index in full term babies was restriction. Noninvasive electrophysiological assessment niea is an evolving area in fetal surveillance and is attracting increasing research interest. Efw 2 sd below mean for gestational age ac ponderal index was statistically reduced 25. It is similar to the body mass index, using a persons height and mass to calculate whether a person is lean or overweight. Sep 11, 2015 we also estimated ponderal indices pis for 230 infants, which is similar to adult body mass index and derived from the following formula.
The ponderal index is similar to the bmi equation in that it measures the leanness or corpulence of a person based on the persons height and weight. Research open access intrauterine growth restriction and. Intrauterine growth retardation diagnosed by rohrers ponderal index and its association with morbidity and early neonatal mortality. This index of the dimensions of a mass density almost fulfills the conditions of a dimensionless measure of the similarity theory, since it is dimensionally independent of the body size and therefore also applicable to children and very large people. Intraoral examinations to determine enamel defect used the fdi modification of the developmental.
Sonographic diagnosis of intrauterine growth retardation using the postnatal ponderal index and the crownheel length as standards of diagnosis. Jan 25, 2016 iugr bw ponderal index was calculated by dividing the bw of the neonate by length 3. Selective intrauterine growth restriction is present when the fetal weight of one twin is below the 10th percentile 1 in one twin of a monochorionic twin pregnancy while the cotwin is of normal size. Low ponderal index or disproportionate iugr has higher neonatal morbidity, particularly in hypoglycemia, perinatal asphyxia, hypothermia. The index is defined as the birth weight divided by the cube of the height.
Intrauterine growth retardation iugr affects 310% of pregnancies. Symmetric iugr is characterized by a similar and proportionate reduction in all auxological parameters, including weight, length, and cranial and abdominal circumference. Neonates have been classified into sga, appropriate for gestational age aga and. As such, they potentially allow the estimation of stunting and wasting that have occurred either in utero or postnatally. Neonatal ponderal index below the 251 centile served as the main outcome measure for diagnosis of iugr. Smallforgestational age sga newborns constitute a special group of. Iugr incidence in newborns would be between 3% and 7% of the total population. Perinatal stress is thought to underlie the barker sequelae of low birth weight, of which precocious pubarche may be a manifestation. Intrauterine growth retardation clinical significance. For assessment of iugr, clinical feature and collarado intrauterine growth chart and ponderal index was used. Preeclampsia in this study is defined as increased blood pressure hypertension after 20 weeks gestation with proteinuria. Intrauterine growth retardation diagnosed by rohrers. Congenital malformations, sga, weight percentile, ponderal index background intrauterine growth restriction iugr can be either symmetric or asymmetric.
Efw 2 sd below mean for gestational age ac pi the ponderal index is a measure of body composition using height and weight. Research article open access predictors of severity and. According to the epidemiological data, intrauterine fetal growth disorders, including fetal macrosomia and fetal growth restriction fgr, are diagnosed in 7. Logistic regression analysis was used to delineate the predictive value of the three fetal growth tests faa, faa velocity and cefw and the additional value of afi and pulsatility index of the umbilical artery. There is however, limited data outlining its utility in evaluating intra uterine growth restriction iugr. Symmetrical intrauterine growth restriction radiology. Crosssectional survey of liveborn, structurally normal, singleton neonates delivered at a tertiary care center in detroit, mich, from 1984 through 1991. In both cases, the variation with age is significant. Fetal growth restriction vanderbilt university medical center.
The ponderal index pi was defined as birthweight in grams. Preterm delivery is defined as delivery before 37 completed weeks gestation. Approach to the child with iugrsga learn pediatrics. Apr 11, 20 intrauterine growth restriction iugr and small for gestational age sga birth have been considered possible indicators of the presence of malformations. Enamel defect of primary dentition in sga children in. Birth weightlength ratios, ponderal indexes, placental. Some are just naturally larger or smaller than others. Intrauterine growth restriction fetal growth abnormality. Modern management of intrauterine growth retardation. Mothers of the iugr children had a significantly higher rate of pregnancy hypertension. The ponderal index pi is arrived at by the following formula. Intrauterine growth restriction is a term used to describe a condition in which the fetus is smaller than expected for the number of weeks of pregnancy. Pis are proxies of infant adiposity and can be further categorized in relation to growth symmetry.
For example, maternal age over 40 years, smoking, other substance abuse alcohol, drugs, severe malnutrition or anemia, advanced diabetes, chronic hypertension, preeclampsia, heavy bleeding during pregnancy, and others. Uvadare digital academic repository diagnostic research. Ponderal definition of ponderal by medical dictionary. Intrauterine growth restriction iugr babies come in all sizes. Pi birth weight x 100 crown heal length3 a ponderal index below the 10th percentile may be used to identify iugr infants correctly. Current pattern of ponderal indices of term smallforgestational age. Ponderal index can be used to identify infants whose soft tissue mass is below normal for the stage of skeletal development. Uvadare digital academic repository diagnostic research in. We aimed to use pi for largeforgestational age lga infants who were born to diabetic or nondiabetic mothers, in. Ductus venosus swaveisovolumetric awave sia index and awave reversed flow in severely premature growthrestricted fetuses. Percentiles for neonates from 30 weeks to 43 weeks of gestation. Approaching the diagnosis of growthrestricted neonates. P171 ponderal index in sga neonates archives of disease in. It is similar to the body mass index, using a persons height and mass to.
Pdf gestational age the most important factor of neonatal. Ponderal index values between 11 and 14 kg m3 are considered as normal. More iugr than aga children were multiple births 31% vs. Precocious pubarche is associated with sga, prematurity. Ponderal index pi is a weightheight related parameter that is mainly used to assess the pattern of fetal growth in smallforgestational age infants. Progression of doppler abnormalities in intrauterine. Value of fetal ponderal index in predicting growth retardation. To look for correlations between the factors of molecular processes in the placentas and gestational age, anthropometrical parameters. Criteria for an index of weight corrected for height are presented and used to investigate, both theoretically and practically, the properties of three weightheight ratios. To find out determinants of low birth weight babies among. A weak but significant correlation between fetal ponderal. In fact, most babies with iugr catch up in height and weight by age 2. Two hundred normal birth weight children were the control group. Longterm neurological and cognitive development of the iugr infant at term have been studied extensively.
Pereira, in fetal and neonatal physiology third edition, 2004. Confusingly, the ponderal index is higher for thin people, and lower for fat people. Arterial morphology and physiology bilateral bmode images of the common carotid, brachial and femoral arteries of the subjects were obtained using vhru, as recently validated for neonatalsized vessels. Ponderal index can also be used to determine the degree of fetal. A proforma was made with respect of history taking, detail physical examination, investigation and treatment. Early postnatal weight gain, intellectual performance, and body mass index at 7 years of age in term infants with intrauterine growth restriction. The data on height, weight and skinfold thickness used in the analysis were collected during the fourth examination of the framingham study. For assessment of gestational age and prematurity extended ballord scoring was used. It is similar to the body mass index, but the mass is normalized with the third power of body. Fortunately, oliver was born at exactly 39 weeks, weighing 5 lb 7. The use and interpretation of ponderal index and other. Current pattern of ponderal indices of term smallfor.
It is also known as the corpulence index ci and the rohrers index, as it was first proposed in 1921 as the corpulence measure by swiss physician fritz rohrer. It is extremely important to use local or national fetal growth graphs in order to avoid some confounding factors. Strategies for detecting later life effects following early. Sgainfant was defined as less than 10th percentile of bga and. Longitudinal progression of doppler abnormalities was evaluated in several ways. Florey department of epidemiology and public health, yale university school of medicine, new haven, conn. Printed in great britain the use and interpretation of ponderal index and other weightheight ratios in epidemiological studies charles du v. Intrauterine growth restriction, head size at birth, and outcome in very preterm infants. It was first proposed in 1921 as the corpulence measure by swiss physician fritz rohrer and hence is also known as rohrers index.
The subjects were 129 sga children aged 942 months, 82 with asymmetrical sga and 47 with symmetrical sga. A fetus with iugr often has an estimated fetal weight that is less than the 10th percentile, or less than 90 percent of all other fetuses of the same gestational age. Various studies have been done to investigate the value of doppler ultrasonography of the umbilical artery and various foetal vessels in the diagnosis and management of iugr. Information and translations of ponderal index in the most comprehensive dictionary definitions resource on the web. Smallforgestational age, intrauterine growth, ponderal index background the term small forgestational age sga describes a baby whose birth weight is less than the 10 th percentile or more than two standard deviations below the mean for age and sex 1 or less than 2.
The ponderal index is a way to measure how obese a person is. The intrauterine ponderal index in relation to birth. Aim of this study is the evaluation of the performance of simple, common indicators of nutritional status, which are used in the identification of growthrestricted neonates. The aim of this study is to evaluate such relationships in a population of newborns, along with other epidemiological and auxological parameters, in particular the ponderal index. To establish the relationship between the fetal ponderal index and birth weight discordance in twins. Expression of the erk and akt pathway in placentas from. Nevertheless, the diagnosis of growthrestricted neonates is as yet an unresolved issue. Symmetrical intrauterine growth restriction is a type of intrauterine growth restriction iugr where all fetal biometric parameters tend to be less than expected below the 10 th percentile for the given gestational age. Despite having a little trouble regulating his blood sugar at first which fortunately, frequent nursing helped with, he was sent home two days later with me. Certainly, their efforts to encourage the medical community to adopt a standard method for quantifying obesity deserve support.
To assess appearance and distribution of the products of homeobox gene hoxb3 in placentas of various gestational ages. Original article ponderal index of low birth weight babies. Parental urinary biomarkers of preconception exposure to. Iugr is when a baby in the womb fails to grow at the expected rate during the pregnancy. Perinatal mortality rates are 48 times higher for growth retarded infants, and morbidity is present in 50% of surviving infants. Another measurement option is the ponderal index, which may be helpful in cases with infants with a low amount of soft tissue mass.
We will also include absolute plasma volume or blood volume as surrogate markers for pve if maternal size is either adjusted for e. Ponderal index definition use our free online ponderal index calculator when you want to quickly make a calculation. Intrauterine growth restriction iugr and small for gestational age sga birth have been considered possible indicators of the presence of malformations. The ponderal index 100 weight in glength in cm 3 of each baby at birth was also computed. A woman who has had a baby with iugr in the past is at risk of having another baby with growth restriction. Variations in birth weight, length and ponderal index pi depend on. Intrauterine growth restriction iugr, a condition that occurs due to various. Iugr frequency will vary depending on the discrimination criteria adopted. When this happens, it is called intrauterine growth restriction, or iugr.
The intrauterine ponderal index in relation to birth weight. Fetal ponderal index is more sensitive than birthweightto. Intrauterine growth restriction iugr describes a fetus that has not reached its growth potential because of genetic or environmental factors. The transitional phase of ductus venosus reversed flow in severely premature iugr fetuses. But if severe, iugr can seriously harm a baby before and after birth. Strategies for detecting later life effects following early life stressors in humans national academies workshop on use of in utero and postnatal indicators to predict health outcomes later in life robert lane, md. Pdf ponderal index fetal weight in grams x 100 fetal length in. For the rohrer index, the situation is different, the changes with age being almost absent.
511 874 1219 1040 1361 1206 903 638 260 564 1438 771 353 574 596 1255 856 769 947 182 968 1122 97 1382 68 513 1455 494 964 1047 756 1345 300 386 1469 700 1054 359 797 479 1001 1314 329 343 275 78 1122 1324