PROVIDENCE – A Women & Infants Hospital physician has been chosen to lead a two-year, $3.7 million project to set a national standard for normal fetal growth, an effort to help doctors better tell when a fetus isn’t developing well and could be born prematurely or with health problems.
Doctors already use fetal growth – as gauged through ultrasounds – as a marker of health and well-being, but there are still limited resources to differentiate between a fetus that’s small but healthy from one that is at risk of complications.
The new project, to be led by Dr. Edward Chien, a physician in the Women & Infants division of maternal-fetal medicine and an assistant professor of obstetrics and gynecology at the Warren Alpert Medical School of Brown University, aims to give doctors clear standards.
With funding from the National Institutes of Health, Chien and his colleagues will recruit up to 700 pregnant women with low risk for prenatal complications, as well as women pregnant with twins and obese women, who face greater risks, for their study.
To evaluate growth patterns by race and ethnicity, the team will recruit specific numbers of Caucasian, Asian, African-American and Hispanic women.
“Growth is a longitudinal measure,” Chien explained in a news release. “We hope to develop an algorithm that will look at fetal size, fetal growth and changes in the body during pregnancy, offering a standard for fetal anthropometric parameters throughout gestation.”
To develop the algorithm, the team will use standard two-dimensional ultrasounds as well as three-dimensional ultrasounds and compare their predictions based on fetal growth with actual newborn weight, looking for factors that can be used to better predict birth weight.
Current algorithms for determining newborn size can be off by up to 15 percent, or one or two pounds, according to Chien. The study will develop algorithms for singletons and twins, aiming to help doctors target resources to the babies who truly need them.
“We know that growth-restricted (small and unhealthy) babies have more complications, such as learning and physical disabilities, and they are more likely to die in utero and after birth,” he said. “But it is important for us to be able to identify those babies who are smaller but healthy so we can utilize resources for monitoring complicated pregnancies. We expend a significant amount of resources on small but healthy fetuses.”
As part of the study, the researchers will also look at three factors that may influence babies’ growth: mothers’ body mass index, prenatal weight gain and nutritional habits.
Along with Chien, the team includes Drs. Hal Pinar and Dwight Rouse at Women & Infants and Dr. Sabrina Craigo at Tufts Medical Center for recruitment.
