Fetal Body Composition and Organ Growth in Pregnancies Complicated by First-Trimester Vaginal Bleeding Status: NICHD Fetal 3D Study

Alexandra Jean-Louis; Jessica L. Gleason; Zhen Chen; Kathryn A. Wagner; Dian He; Roger Newman; William A. Grobman; Robert Gore-Langton; Seth Sherman; Magdalena Sanz Cortes; Edward K. Chien; Luis F. Goncalves; Jagteshwar Grewal; Katherine L. Grantz

doi:10.1055/a-2682-5886

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol
DOI: 10.1055/a-2682-5886

Original Article

Fetal Body Composition and Organ Growth in Pregnancies Complicated by First-Trimester Vaginal Bleeding Status: NICHD Fetal 3D Study

Authors

Alexandra Jean-Louis

¹Division of Population Health Research, Division of Intramural Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States
Jessica L. Gleason

¹Division of Population Health Research, Division of Intramural Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States
Zhen Chen

²Division of Population Health Research, Division of Intramural Research, Biostatistics and Bioinformatics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States
Kathryn A. Wagner

¹Division of Population Health Research, Division of Intramural Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States
Dian He

³The Prospective Group, Inc., Fairfax, Virginia, United States
Roger Newman

⁴Department of Obstetrics and Gynecology, Division of Reproductive Sciences, Medical University of South Carolina, Charleston, South Carolina, United States
William A. Grobman

⁵Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
Robert Gore-Langton

⁶The Emmes Company, Rockville, Maryland, United States
Seth Sherman

⁶The Emmes Company, Rockville, Maryland, United States
Magdalena Sanz Cortes

⁷Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, United States
Edward K. Chien

⁸Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, United States
Luis F. Goncalves

⁹Department of Radiology, Phoenix Children's Hospital, Phoenix, Arizona, United States
Jagteshwar Grewal

¹⁰Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States
Katherine L. Grantz

¹Division of Population Health Research, Division of Intramural Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States

Abstract

Objective

This study aimed to explore associations between self-reported first-trimester vaginal bleeding status and fetal body composition and organ volumes measured by three-dimensional (3D) ultrasound across pregnancy.

Study Design

The NICHD Fetal 3D Study (2015–2019) included individuals with singleton pregnancies at low risk for fetal growth abnormalities (n = 2,634). Fetal body composition measures of arm, abdomen, and thigh, and organ volumes including cerebellum, lung, kidney, and liver, were measured up to five times between 15 and 40 weeks using 3D ultrasound. Women were grouped by cumulative days of self-reported first-trimester vaginal bleeding: 0 (no bleeding, reference), 1, or >1 day. Linear mixed models, with quadratic and cubic terms for gestational age, including global tests for overall differences in trajectories and weekly pairwise comparisons, were fit to compare groups by fetal anthropometric measures, adjusted for maternal age, race/ethnicity, prepregnancy body mass index, parity, and infant sex.

Results

Most women had no bleeding (n = 2,144, 81.4%), whereas 211 (8.0%) reported 1 day and 279 (10.6%) reported >1 day. Compared with no bleeding, fetuses of women with >1 day of bleeding had 75.1 to 264.0 mm² smaller abdominal area between 30 and 40 weeks, 1.1 to 4.0 cm³ smaller fractional thigh volume between 33 and 40 weeks, 0.4 to 2.4 cm³ smaller fractional fat thigh volumes between 30 and 40 weeks, and 0.8 to 1.6 cm³ larger cerebellar volumes between 35 and 40 weeks. Fetuses of women with 1 day of bleeding had 2.6 to 4.8 cm³ smaller liver volume between 26 and 35 weeks compared with no bleeding.

Conclusion

First-trimester bleeding was associated with smaller fetal abdominal area and decreased adiposity compared with no bleeding, whereas organ growth trajectories were increased for the cerebellum and decreased for the liver. Fetal 3D measures may provide insight into how first-trimester gestational bleeding potentially influences fetal growth and development with implications for possible postnatal health outcomes.

Key Points

First trimester bleeding group had smaller abdomen and liver and larger cerebellum.
Thigh fat was smaller in women with moderate/severe and consistent bleeding across pregnancy.
Fetal volume differences may improve understanding of bleeding and fetal growth.

Keywords

first-trimester bleeding - fetal growth - body composition - organ growth - fetal development

Volltext

Referenzen

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