US/World

First-Ever International Standards Set For Fetal Development And Newborn Size

Pregnancy
The first-ever global guidelines for fetal development reflect how babies should grow when mothers have adequate health, nutrition, and medical care. Reuters

From this point forward, all 120 million babies born each year around the globe will be assessed by a common set of standards. An international team led by scientists from Oxford University developed the first-ever global guidelines for fetal development and newborn size, and as such, they reflect how babies should grow when mothers have adequate health, nutrition, and medical care.

It is a heart-rending chain of events: Poor fetal growth results in small birth size, which in turn is linked to illness and early death in infancy and childhood. Deficient development in the womb not only harms babies and children but also impacts adult health by increasing the risk of diabetes, high blood pressure, and cardiovascular disease. In developed and emerging countries, being born overweight is a worsening problem as a result of rising maternal obesity rates due to overnutrition. While overweight babies escape death in infancy, they face a higher risk of diabetes and high blood pressure later in life.

Although the dangers of underweight and overweight babies are well known to health care professionals worldwide, over 100 different, locally produced, growth charts are used at present to assess fetal growth and newborn size around the world. Too often, these describe how babies grew in a particular population or region at a given time and do not define optimal healthy growth.

Funded by the Bill & Melinda Gates Foundation, the international standards project (officially known as the INTERGROWTH-21st Project) was unprecedented in scale and size and involved the recruitment of nearly 60,000 women and a team of more than 300 researchers and clinicians. Based on their work, the new standards provide 3rd, 10th, 50th, 90th and 97th centile curves for the growth of a baby during pregnancy (as measured by ultrasound) and for a baby's size at birth according to gestational age (weight, length and head circumference).  

“Being able to identify millions of additional undernourished babies at birth provides an opportunity for them to receive nutritional support and targeted treatment, without which close to five percent are likely to die in their first year or develop severe, long-term health problems,” said Dr. José Villar, senior author of the study initiating the standards and professor at Oxford. “The huge improvement in health care we can achieve is unprecedented.”

And the predicted improvments will encompass not only the poorest of countries but also the richest. “In developed countries, introducing the standards will lead to more infants being diagnosed at birth as overweight and treated earlier to prevent chronic diseases later in life,” said Dr. Julian Robinson of Harvard Medical School.

Source: Papageorghiou AT, Kennedy SH, Salomon LJ, et al. International standards for early fetal size and pregnancy dating based on ultrasound measurement of crown-rump length in the first trimester. Ultrasound in Obstetrics & Gynecology. 2014.

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