Abstract
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.
Publication types
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Clinical Trial
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Randomized Controlled Trial
MeSH terms
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Abortion, Spontaneous / etiology*
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Adolescent
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Adult
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Bangladesh
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Crown-Rump Length
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Female
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Fetal Growth Retardation / physiopathology*
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Gestational Age
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Humans
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Maternal Age
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Parity / physiology
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Pregnancy
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Pregnancy Trimester, First / physiology*
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Prospective Studies
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Rural Population
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Ultrasonography, Prenatal / methods
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Young Adult
Grants and funding
This work was supported by the Japan Society for the Promotion of Science (JSPS
https://www.jsps.go.jp/english; Grant No. 182566005; YW). The MINIMat Study was conducted by International Centre for Diarrhoeal Disease Research, Bangladesh (
http://www.icddrb.org) funded by United Nations Children’s Fund (
http://www.unicef.org), Swedish International Development Cooperation Agency (
http://www.sida.se), Medical Research Council (
https://www.gov.uk/government/organisations/medical-research-council), Swedish Research Council (
https://www.vr.se), the Department for International Development (UKAid
https://www.gov.uk/government/organisations/department-for-international-development), Japan Society for the Promotion of Science (
https://www.jsps.go.jp), Uppsala University
http://www.uu.se), and the United States Agency for International Development (
https://www.usaid.gov). Icddr,b acknowledges the following donors who provided unrestricted support: Australian Agency for International Development, Canadian International Development Agency, the Department for International Development, Government of the People’s Republic of Bangladesh, Kingdom of the Netherlands, Swiss Agency for Development and Cooperation, and Swedish International Development Cooperation Agency. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.