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First-trimester fetal growth restriction and the occurrence of miscarriage in rural Bangladesh: A prospective cohort study
Int Ctr Diarrheal Dis Res Bangladesh, Dhaka, Bangladesh.;Univ Tsukuba, Grad Sch Comprehens Human Sci, Tsukuba, Ibaraki, Japan..
Univ Tsukuba, Fac Med, Dept Clin Trial & Clin Epidemiol, Tsukuba, Ibaraki, Japan..
Univ Tsukuba, Grad Sch Comprehens Human Sci, Tsukuba, Ibaraki, Japan..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 7, article id e0181967Article in journal (Refereed) Published
Abstract [en]

Fetal growth restriction in early pregnancy increases the risk of adverse pregnancy outcome, which has a significant social and psychological impact on women. There is limited information related to community-based study to evaluate early indicators related to miscarriage. The aim of this study is to examine the relationship between fetal growth restriction, measured by ultrasound crown-rump length (CRL), and subsequent occurrence of miscarriage in pregnant women in rural Bangladesh. The study was conducted within the Maternal and Infant Nutrition Interventions Trial in Matlab (MINIMat study), Bangladesh. A total of 4436 pregnant women were enrolled in the study when they were at less than 14 gestational weeks. The expected CRL was determined based on an established growth curve of gestational age and CRL, and deviation from this curve of CRL was expressed as a z-score. After identifying related covariates, the multiple Poisson regression model was used to determine the independent contribution from the CRL to miscarriage. A total of 3058 singleton pregnant women were included in analyses, with 92 miscarriages and 2966 continued pregnancies. The occurrence of miscarriages was significantly higher in the smaller categories of CRL z-score after adjustments for maternal age, parity, early pregnancy BMI, gestational age at CRL measurement and socioeconomic status (adjusted relative risk [95% confidence interval]: 1.03 [1.02 - 1.05] for less than -2 z-score). In a rural Bangladesh population, smaller than expected CRL for the gestational age was related to subsequent miscarriage. Ultrasound biometry information together with careful clinical assessment should provide much needed attention and care for pregnant women.

Place, publisher, year, edition, pages
2017. Vol. 12, no 7, article id e0181967
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Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
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URN: urn:nbn:se:uu:diva-333526DOI: 10.1371/journal.pone.0181967ISI: 000406643100072PubMedID: 28732073OAI: oai:DiVA.org:uu-333526DiVA, id: diva2:1157289
Available from: 2017-11-15 Created: 2017-11-15 Last updated: 2017-11-29Bibliographically approved

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