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Objective: To assess if fetal size at the time of ultrasound dating examination is associated with the risk of macrosomia and complications associated with macrosomia., Methods: This was a retrospective cohort study of 19 377 singleton pregnancies dated in gestational weeks 16-20 during the period 1998-2004 at Danderyd Hospital, Stockholm, Sweden. Obstetric outcome was assessed through linkage to the Swedish Medical Birth Register., Results: When fetuses were > or = 7 days larger than expected at dating, compared with the expected size according to last menstrual period, there was a 59% increase in the risk of birth weight > or = 4500 g and a 145% increase in the risk of birth weight > or = 5000 g (odds ratio (OR), 1.59; 95% CI, 1.12-2.24 and OR, 2.45; 95% CI, 1.22-4.90, respectively). For a birth weight of > or = 4000 g the risk estimate was 1.19 (95% CI, 0.96-1.47)., Conclusion: Fetuses that are larger than expected in the second trimester have an increased risk of macrosomia. This emphasizes that fetal size in early pregnancy is not only a function of gestational duration, but also of fetal growth. However, only a limited proportion of all infants born macrosomic can be identified as such at the time of ultrasound dating., (Copyright 2009 ISUOG. Published by John Wiley & Sons, Ltd.)

BACKGROUND Low birth weight is an often-reported risk factor for high blood pressure later in life. This study investigates the selective contributions of preterm birth and poor fetal growth to later risk of hypertension. METHODS A total of 250,000 Swedish birth records from 1925 through 1949 were examined. All subjects born with a gestational duration below 35 weeks and/or a birth weight ≤2,000 g (girls) or ≤2,100 g (boys) were included, as well as an equal number of controls. This yielded a cohort of 6,269 subjects, of which 2,502 were born at <35 weeks of gestation, and 1,226 subjects had a birth weight ≤2,000 g (girls) or ≤2,100 g (boys). The main outcome measure was diagnosis of hypertension in the Swedish Hospital Discharge Register from 1987 through 2006. RESULTS There were 838 cases of hypertension in the cohort. Birth weight was negatively associated with hypertension (P for trend ≤ 0.0005). This effect was explained by poor fetal growth: when compared with subjects with a normal fetal growth, those born small for gestational age had a 54% increase in risk of hypertension. In contrast, there was no association between gestational duration and hypertension. CONCLUSIONS For those born in the first half of the twentieth century, the association between low birth weight and adult hypertension is due to poor fetal growth and not due to preterm birth. [ABSTRACT FROM AUTHOR]

Objective To analyse the association between fetal size at time of dating ultrasound and risk for preterm delivery and small-for-gestational-age (SGA) birth and to evaluate if timing of ultrasound, that is before 14 weeks of gestation or after 16 weeks affects this association. Design Retrospective cohort study. Setting Ultrasound departments of Ultragyn, Stockholm, Sweden. Population A total of 28 776 singleton pregnancies dated between 1998 and 2004. Methods Obstetric outcome was assessed through linkage of the cohort to the Swedish Medical Birth Register. Main outcome measures Risks of preterm delivery, low birthweight for gestational age, pre-eclampsia, asphyxia, respiratory distress, instrumental delivery, caesarean section, and postterm birth were calculated for the groups dated early and late. Results When the expected date of delivery was postponed after ultrasound dating by 7 days or more, there was an increased risk for preterm delivery and pre-eclampsia in the late dating group (OR 1.49, 95% CI 1.27–1.73 and OR 1.27, 95% CI 1.02–1.60, respectively) but not in the early dating group. In both dating groups, there was an increased risk for SGA birth (OR 1.77, 95% CI 1.13–2.78 and OR 2.09, 95% CI 1.59–2.73, respectively) There was no increased risk for any of the other diagnoses. Conclusion Our study gives further support to the notion that intrauterine growth restriction may be present as early as the first trimester. Accordingly, our study also suggests that surveillance of pregnancies with postponed estimated date of delivery may provide means for increased detection of fetal growth restriction. [ABSTRACT FROM AUTHOR]