Fetal growth restriction in rural Bangladesh: a prospective study

Fetal growth restriction (FGR) and low birth weight(LBW) are serious public health problems. In developing countries, the incidence of low birth weight is predominantly the result of FGR, and both low birth weight and FGR are associated with neonatal death and later growth and development. Fetal growth charts are important for assessing the size of the fetus during pregnancy. The aims of this study were to describe the fetal growth pattern of a population in rural Bangladesh where maternal undernutrition is prevalent and to compare the timing of FGR in that population with WHO and INTERGROWTH- 21st international reference values. From November 2001 to October 2003, pregnant women were recruited in Matlab, a sub district of Bangladesh, and underwent three follow-up ultrasound examinations during pregnancy for measurement of the parameters of the fetal head, abdomen, and femur. The data were fitted to a linear-cubic model, and the derived values were compared with international reference values. A total of 2678 singleton pregnancies were included in the analyses. The mean (SD) maternal age was 25.9 (5.8) years (range, 14-47 years). The mean (SD) early pregnancy BMI was 20.1 (2.6) kg/m , and 27.6% of the women were underweight (BMI