# name
Factors associated with ultrasound-aided detection of suboptimal
                fetal growth in a malaria-endemic area in Papua New Guinea

# metadata.dc.description.abstract[].value
BACKGROUND: Fetal growth restriction (FGR) is associated with
                increased infant mortality rates and ill-health in adulthood.
                Evaluation of fetal growth requires ultrasound. As a result,
                ultrasound-assisted evaluations of causes of FGR in
                malaria-endemic developing countries are rare. We aimed to
                determine factors associated with indicators of abnormal fetal
                growth in rural lowland Papua New Guinea (PNG). METHODS: Weights
                and growth of 671 ultrasound-dated singleton pregnancies (<25
                gestational weeks) were prospectively monitored using estimated
                fetal weights and birthweights. Maternal nutritional status and
                haemoglobin levels were assessed at enrolment, and participants
                were screened for malaria on several occasions. FGR was
                suspected upon detection of an estimated fetal weight or
                birthweight <10(th) centile (small-for-gestational age)
                and/or low fetal weight gain, defined as a change in weight
                z-score in the first quartile. Factors associated with fetal
                weight and fetal weight gain were additionally assessed by
                evaluating differences in weight z-scores and change in weight
                z-scores. Log-binomial and linear mixed effect models were used
                to determine factors associated with indicators of FGR. RESULTS:
                SGA and low weight gain were detected in 48.3% and 37.0% of
                pregnancies, respectively. Of participants, 13.8%, 21.2%, and
                22.8% had a low mid-upper arm circumference (MUAC, <22 cms),
                short stature (<150 cms) and anaemia (haemoglobin <90 g/L)
                at first antenatal visit. 24.0% (161/671) of women had at least
                one malaria infection detected in peripheral blood. A low MUAC
                (adjusted risk ratio [aRR] 1.51, 95% CI 1.29, 1.76, P <
                0.001), short stature (aRR 1.27, 95% CI 1.04, 1.55, P = 0.009),
                and anaemia (aRR 1.27, 95% CI 1.06, 1.51, P = 0.009) were
                associated with SGA, and a low body mass index was associated
                with low fetal weight gain (aRR 2.10, 95% CI 1.62, 2.71, P <
                0.001). Additionally, recent receipt of intermittent preventive
                treatment in pregnancy was associated with increased weight
                z-scores, and anaemia with reduced change in weight z-scores.
                Malaria infection was associated with SGA on crude but not
                adjusted analyses (aRR 1.13, 95% CI 0.95, 1.34, P = 0.172).
                CONCLUSION: Macronutrient undernutrition and anaemia increased
                the risk of FGR. Antenatal nutritional interventions and malaria
                prevention could improve fetal growth in PNG.

# metadata.dc.relation.ispartof[].value
BMC Pregnancy and Childbirth, 2015, vol. 15, num. 83, 8 p.

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Factors associated with ultrasound-aided detection of suboptimal
                fetal growth in a malaria-endemic area in Papua New Guinea