WHO Multicentre Study For The Development Of Growth
Standards From Fetal Life To Childhood:
The Fetal Component
Study Protocol
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Executive
Summary
Objective: To
conduct a multinational study for the development of fetal growth standards
for international application by assessing fetal growth under nutritionally
unrestricted conditions in populations of different ethnic and geographic
backgrounds. Global perspective: Each year approximately four million
newborns and 500,000 pregnant women die due to complications related to
pregnancy and childbirth. Almost all (99 %) of these deaths occur in the
poorest countries of the world, and are potentially preventable through
proven interventions. These figures represent one of the starkest health
inequities of our time, and indicate that the most disenfranchised are often
denied the basic human right to life and safe reproduction.
Two main sources of bias are foreseen. The need
for compliance with strict antenatal ultrasound controls more frequently
than recommended in routine care could contribute to select a specific
population. The second concern is that the strict inclusion criteria may
result in a sample with low variability in growth. This will be counteracted
by pooling data from different countries and by not imposing any maternal
anthropometric restrictions on the study sample.
Outcome:
The main outcome of the
proposed study will be the development of
fetal growth standards (either global or
population specific) for international applications that will be
integrated into the WHO Child Growth Standards. These standards will have
important clinical and research implications for the prenatal and postnatal
periods, as well as for maternal health. The multinational cohorts examined
in the study could provide the basis for long term follow-up studies
extending into adulthood to investigate the fetal origins of chronic
diseases.
