Optimal fetal growth: a misconception?
Alterations in fetal growth trajectory, either in terms of individual organs or the fetal body, constitute part of a suite of adaptive responses that the fetus can make to a developmental challenge such as inadequate nutrition. Nonetheless, despite substantial changes in nutrition in many countries over recent centuries, mean birthweight has changed relatively little. Low birthweight is recognized as a risk factor for later noncommunicable disease, although the developmental origins of such risk are graded across the full range of fetal growth and birthweight. Many parental and environmental factors, some biological and some cultural, can influence fetal growth, and these should not be viewed as abnormal. We argue that the suggestion of establishing a universal standard for optimal fetal growth ignores the breadth of these normal fetal responses. It may influence practice adversely, through incorrect estimation of gestational age and unnecessary elective deliveries. It raises ethical as well as practical issues.
['Hanson|Mark|M|', 'Kiserud|Torvid|T|', 'Visser|Gerard H A|GH|', 'Brocklehurst|Peter|P|', 'Schneider|Eric B|EB|']
D001724:Birth Weight D005260:Female D047109:Fetal Development D005317:Fetal Growth Retardation D048070:Fetal Nutrition Disorders D005865:Gestational Age D057238:Growth Charts D006801:Humans D007230:Infant, Low Birth Weight D007231:Infant, Newborn D008297:Male D011247:Pregnancy D012016:Reference Values
fetal growth trajectory inadequate nutrition low birthweight