INTRAUTERINE GROWTH RESTRICTION AND FETAL BODY COMPOSITION

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Background Potential usefulness of ultrasonographically generated estimates of fetal fat for the determination and evaluation of fetal growth abnormalities. In the newborn, the fat mass (ranging from 12% to 14% of the whole birth-weight) has been demonstrated to account for 46% of the variance in neonatal weight. Catalano PM, Tyzbir ED et al. Obstet Gynecol 1992; 79:46-50. In infants of diabetic mothers subcutaneous fat is more closely associated than birth-weight with maternal glucose control. Whitelaw A et al. Lancet 1977;1:15-8.

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Background Previous screening tools for fetal macrosomia detection STT of the thigh STT of the humerus STT of abdomen Cheek to cheek diameter Subcutaneous tissue thickness (STT) Highly efficient screening method for macrosomia based upon the subcutaneous tissue widht/femur length ratio Santolaya-Forgas et al. Am J Obstet Gynecol 1994; 171:1072-5. Sensitivity 82% Specificity 96% Bias: glucose tolerance not taken into account

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Background Subcutaneous tissue width/femur length ratio: a poor predictor of fetal macrosomia in the non-diabetic pregnancy. Rotmensch et al. Ultrasound Obstet Gynecol 1999;13:340-344. But…. in a selected population

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Background The use of a simple linear measurement of fat thickness across the extremity was found to be poorly reproducible, with an intra-observer coefficient of variation of 28%. Bernstein M et al. Am J Obstet Gynecol 1997;176:28-32. In infants of diabetic mothers subcutaneous fat is more closely associated than birth-weight with maternal glucose control. Whitelaw A et al. Lancet 1977;1:15-8. Increased neonatal fat, indipendent of birth weight, is associated with a significant increase in the risk of birth by CS in infant of women with gestational diabetes. Bernstein IM et al. J Perinat Med 1982;10:42-7. The assumption that birth weight could be predicted by sonographic measurements of fetal STT is plausible.

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