Foetal head growth patterns can indicate subsequent development of the child, researchers reported last night.
Researchers at the University of Oxford, UK, have, for the first time, identified 20 to 25 weeks’ gestation as the starting point for five growth patterns of the foetal head with developmental, behavioural, visual and growth outcomes.
They say their findings, published in the latest Nature Medicine, provide strong evidence that childhood development is influenced by events affecting the mother before and/or during pregnancy.
The team monitored the growth of more than 3,500 babies in utero in Brazil, Kenya, Pakistan, South Africa, Thailand and the UK, countries, using serial ultrasound scans throughout pregnancy, and continued to monitor their growth and development until they reached two years old.
Co-study leader Aris Papageorghiou, professor of foetal medicine at the University of Oxford, said the study is unique because each pregnancy was accurately dated by ultrasound at less than 14 weeks’ gestation and all foetuses were scanned with the same type of ultrasound machine every five weeks throughout pregnancy.
“All the ultrasonographers were trained to measure the growth of the foetuses in a standardised manner,” he said.
“Much has been said about the importance of the first 1000 days of life in determining future health outcomes. In this study we have shown distinct patterns of foetal head growth during pregnancy and how they relate to infant outcomes.
“The greatest concern clinically relates to faltering foetal head growth, starting from around 20 to 25 weeks’ gestation, that has the strongest negative effect on cognitive, fine motor, language and visual development at two years of age.”
Stephen Kennedy, professor of reproductive medicine at the University of Oxford, who co-led the study, described it as a landmark study that strongly indicates prenatal and intrauterine environments determine the growth and development of infants across the world.
“Policymakers must take notice of these findings to ensure that mothers enter pregnancy as healthy as possible and receive good, evidence-based care from the first trimester of pregnancy onwards,” he said.
“In future, we hope to identify biomarkers in babies at birth indicative of faltering intrauterine growth of the foetal head as an alternative to having to carry out repeated ultrasound scans so as to determine which newborns might benefit from targeted interventions to improve developmental outcomes.”
Fetal cranial growth trajectories are associated with growth and neurodevelopment at 2 years of age: INTERBIO-21st Fetal Study. Nature Medicine 18 March 2021
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