05:39am Thursday 19 October 2017

Irish discovery challenges international practice for predicting risk or complication for small babies in the womb

‘The challenge to distinguish small but normal babies from small at-risk babies, is one of the most common, controversial and complex problems in modern obstetrics,’ says lead researcher Julia Unterscheider, at the Royal College of Surgeons in Ireland. ‘Standard international practice has been to consider those babies in the bottom 10% by weight to be at the highest risk of developing complications. These mothers and babies usually receive increased surveillance and monitoring. However, our study questions whether this is necessary for all cases’.

The majority of babies whose weight falls into the bottom 10% from a weight perspective go on to be a healthy baby that is simply small for its gestational age.  However, some develop serious health complications, and possibly even die. And there is recent evidence to suggest that unfavourable conditions in the womb may increase risk of diseases in adulthood such as hypertension, diabetes, coronary heart disease and stroke. So it is believed that close monitoring of this 10 per cent is necessary.

‘However, we conducted a study involving over 1,100 pregnant women at seven maternity hospitals across Ireland using state-of-the-art ultrasound equipment supplied by the Health Research Board (HRB), which allow very detailed monitoring of babies in the womb. We took a set of in-depth ultrasound measurements normally at two-weekly intervals, or more frequent if deemed appropriate, and recorded the baby’s medical status and condition following delivery.

The findings revealed that the highest risk for adverse outcomes are in the group of babies that fall into the bottom three per cent by weight and who have an abnormal reading on the ultrasound test that measures arterial blood flow in the umbilical cord.

‘In fact, the measurement of blood flow in the umbilical cord was the strongest and most significant predictor of an increased likelihood of complications,’ explains Dr Unterscheider. ‘Our data calls into question whether monitoring all of those in the bottom 10% by weight alone is necessary when predicting adverse outcomes’.

Fergal Malone, Chairman of the Perinatal Ireland Research Consortium commented; ‘The major benefit of this study is the potential to radically change the focus and intensity of current assessment for the apparently small baby in the womb.’

The findings will also be published in full in the March edition of the American Journal of Obstetrics & Gynecology.

ENDS

For more information, contact

Gillian Markey
Communications Manager
Health Research Board
t 00353 1 2345103
m 00353 87 2288514
e gmarkey(at)hrb.ie

Notes to editors

The Health Research Board (HRB) is Ireland’s lead agency supporting and funding health research. The HRB’s mission is to improve people’s health, patient care and health service delivery by leading and supporting research, generating new knowledge, as well as promoting the application of evidence in policy and practice. To date, the HRB has supported a wide range of research which has played a key role in driving innovation in Ireland’s health system and supporting economic development.

Perinatal Ireland is a multi-centre, all-Ireland research consortium focusing on carrying out research into women’s and children’s health. The consortium is funded through an Imaging Award from the Health Research Board (HRB). It is the first such group in Ireland and links seven maternity hospitals across the island of Ireland, harnessing the expertise of Ireland’s leading maternal fetal medicine specialists. The initiative is coordinated by the Royal College of Surgeons in Ireland.

The consortium provides a unique, world-class research infrastructure, comprising state-of-the-art imaging equipment, dedicated research and management personnel together with a central management and governance structure. With access to large patient populations, Perinatal Ireland is uniquely positioned to carry-out innovative and ground-breaking clinical and translational research.


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