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16.03.2016 | Original Article

More than fetal urine: enteral uptake of amniotic fluid as a major predictor for fetal growth during late gestation

verfasst von: Soyhan Bagci, Erwin Brosens, Dick Tibboel, Annelies De Klein, Hanneke Ijsselstijn, Charlotte H. W. Wijers, Nel Roeleveld, Ivo de Blaauw, Paul M. Broens, Iris A. L. M. van Rooij, Alice Hölscher, Thomas M. Boemers, Marcus Pauly, Oliver J. Münsterer, Eberhard Schmiedeke, Mattias Schäfer, Benno E. Ure, Martin Lacher, Vera Choinitzki, Johannes Schumacher, Nadine Zwink, Ekkehart Jenetzky, David Katzer, Joerg Arand, Peter Bartmann, Heiko M. Reutter

Erschienen in: European Journal of Pediatrics | Ausgabe 6/2016

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Abstract

The purpose of our study was to investigate the importance of amniotic fluid (AF) for fetal growth during late gestation using esophageal atresia (EA) patients as a model. In this retrospective cohort study, we compared the z-scores adapted for birth weights (BW z-scores) for each of 517 European newborns with congenital pre-gastric intestinal atresia, i.e., EA, to a European reference population. To account for the influence of the intestinal atresia on fetal growth per se, we compared adapted birth weights for each of 504 European newborns with post colonic intestinal atresia (anorectal malformation (ARM) with atresia of the anus) to the same European reference population. Analysis of the complete cohort showed (i) a significantly higher rate of small for gestational age newborns among EA compared to ARM newborns (p < 0.001) and (ii) significantly lower BW z-scores among EA compared to ARM newborns (p < 0.001). BW z-scores of EA newborns were significantly lower in term compared to preterm newborns with an inverse correlation with gestational age (GA) (Spearman correlation coefficient, r = −0.185, p < 0.001).

Conclusions: Enteral uptake of AF seems to play a pivotal role in fetal growth during late gestation.

What is Known:

• Peak velocity of fetal weight gain occurs at 33 weeks of gestation and continues until birth. During this period, fetal growth is mainly characterized by cellular hypertrophy.

• Amniotic fluid (AF) comprises large amounts of hormones and growth regulators.

What is New:

• A significantly higher rate of small for gestational age and lower birth weights and z-scores are observed among newborn infants with congenital pre-gastric intestinal atresia.

• These findings suggest that enteral uptake of AF is a major predictor for fetal growth during late gestation.

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Titel: More than fetal urine: enteral uptake of amniotic fluid as a major predictor for fetal growth during late gestation
verfasst von: Soyhan Bagci
Erwin Brosens
Dick Tibboel
Annelies De Klein
Hanneke Ijsselstijn
Charlotte H. W. Wijers
Nel Roeleveld
Ivo de Blaauw
Paul M. Broens
Iris A. L. M. van Rooij
Alice Hölscher
Thomas M. Boemers
Marcus Pauly
Oliver J. Münsterer
Eberhard Schmiedeke
Mattias Schäfer
Benno E. Ure
Martin Lacher
Vera Choinitzki
Johannes Schumacher
Nadine Zwink
Ekkehart Jenetzky
David Katzer
Joerg Arand
Peter Bartmann
Heiko M. Reutter
Publikationsdatum: 16.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Pediatrics / Ausgabe 6/2016
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-016-2713-y

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More than fetal urine: enteral uptake of amniotic fluid as a major predictor for fetal growth during late gestation

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