November 2019 · Volume 8 · Issue 11 Page 4400
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ravi AK et al. Int J Reprod Contracept Obstet Gynecol. 2019 Nov;8(11):4400-4405
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Fetal growth in low-risk Indian population at a tertiary centre and its
comparison with INTERGROWTH-21 standards: a prospective
cohort study
Anoosha K. Ravi
1
, Krishna Agarwal
1
*, Siddarth Ramji
2
, Sreenivas Vishnubhatla
3
INTRODUCTION
The sources for percentile charts to guide intrauterine
growth are normograms constructed from population in
USA or Europe (e.g.; Alexander et al, Brenner et al,) or
from mothers with known constraints to growth.
1,2
Similar to the WHO reference standards available for
growth monitoring from 0 to 5 years of age, a global
initiative was taken to develop global reference standards
for intrauterine fetal growth monitoring and was
published as INTERGROWTH 21; International fetal and
new-born growth consortium for the 21
st
century.
3,4
This
was a prescriptive study involving affluent educated
mothers. With this available international standard, the
fetal growth of local population is studied which
constitutes mostly socioeconomically disadvantaged
mothers and thence the study will impress upon how
fetuses from non-affluent population grow as compared
to the international growth standards.
ABSTRACT
Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with
the INTERGROWTH-21 standards.
Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An
experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head
circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric
measurements were taken within 12 hours of childbirth.
Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until
delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed
lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7)
as compared to INTERGROWTH-21 standards. From 1
st
through 5
th
visit, the z scores for BPD and HC improved
whereas declined for AC and FL.
Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to
INTERGROWTH-21 standards.
Keywords: Abdominal circumference, Biparietal diameter, Femur length, Intrauterine fetal growth, Percentile charts,
Ultrasound parameters
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194864
1
Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India
2
Department of Neonatology, Maulana Azad Medical College, New Delhi, India
3
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Received: 09 September 2019
Accepted: 04 October 2019
*Correspondence:
Dr. Krishna Agarwal,
E-mail: drkrishna.agarwal@gmail.com
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