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Biparietal diameter (BPD) in millimeters for boys and girls from 20 to 30 weeks of gestation for percentiles 5, 10, 50, 90, and 95
Source publication
Background:
According to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes.
Methods:
First, second, and third trimester fetal ultrasound examina...
Context in source publication
Context 1
... each parameter, the 5th, 10th, 50th, 90th, and 95th centiles were constructed. Actual values for these centiles and grid curves are outlined in Additional file 4. Comparing the two gender growth trajectories and their percentiles, for BPD, there was a significant (p < 0.001) difference for all percentiles in boys having higher BPD measurements ( Fig. 2, Table 3). At 24 weeks, the 50th percentile BPD for boys (60.4 mm) is significantly higher as compared to girls (58.9 mm, p < 0.001; Additional file 5). This corresponds to a difference of three gestational days. The boys' 5th percentile aligns with the 10th percentile of the girls, and the 90th percentile aligns with the 95th ...
Citations
... Whereas males favor fetoplacental growth, allowing them to grow faster from a very early age (Galjaard et al., 2019), females favor fetoplacental reserve, strengthening their risk mitigation under adverse maternal conditions (Meakin et al., 2021). During periods of temperature stress, alterations to developing systems are likely to be different between males and females. ...
Objectives
External environmental heat exposure during gestation impacts the physiology of human development in utero, but evidence for these impacts has not yet been explored in dentition. We examined deciduous teeth for fluctuating asymmetry (FA), a measure of developmental instability, together with gestational environmental temperature data drawn from historical weather statistics.
Materials and Methods
We measured dental casts from the longitudinal Burlington Growth Study, representing 172 participants (ages 3–6 years) with health records. FA was calculated from crown dimensions and intercuspal distances that develop during gestation. Multiple regression separated by sex ( n female = 81) examined the effects of mean temperatures in each trimester, controlling for birth year.
Results
In females, increased temperatures during the first trimester are significantly associated with an increase in FA ( p = 0.03), specifically during the second and third prenatal months ( p = 0.03). There is no relationship between temperature and FA for either sex in the second or third trimesters, when enamel is formed.
Discussion
Dental instability may be sensitive to temperature in the first trimester in females during the scaffolding of crown shape and size in the earliest stages of tooth formation. Sexual dimorphism in growth investment strategies may explain the differences in results between males and females. Using enduring dental characteristics, these results advance our understanding of the effects of temperature on fetal physiology within a discrete period.
... A few studies found that female fetuses present smaller HC, starting from the second trimester of pregnancy [25][26][27][28]. In a recent study, gender-customized curves based on a cohort of 11,404 fetal measurements showed that the male HC curve was significantly higher than the female curve for all gestational weeks [28]. ...
Introduction
Microcephaly, characterized by abnormal head growth, can often serve as an initial indicator of congenital, genetic, or acquired disorders. In this study, we sought to evaluate the effectiveness of chromosomal microarray (CMA) testing in detecting abnormalities in both prenatal and postnatal cases of microcephaly.
Materials and methods
CMA Testing: We conducted CMA testing on 87 prenatally-detected microcephaly cases and 742 postnatal cases at a single laboratory. We evaluated the CMA yield in relation to specific clinical characteristics.
Results
In prenatal cases, pathogenic and likely pathogenic (LP) results were identified in 4.6% of cases, a significantly higher rate compared to low-risk pregnancies. The male-to-female ratio in this cohort was 3, and the CMA yield was not influenced by gender or other clinical parameters. For postnatal cases, the CMA yield was 15.0%, with a significantly higher detection rate associated with dysmorphism, hypotonia, epilepsy, congenital heart malformations (CHM), learning disabilities (LD), and a history of Fetal growth restriction (FGR). No specific recurrent copy number variations (CNVs) were observed, and the rate of variants of unknown significance was 3.9%.
Conclusions
The yield of CMA testing in prenatal microcephaly is lower than in postnatal cases (4.6% vs. 15%). The presence of microcephaly, combined with dysmorphism, hypotonia, epilepsy, CHD, LD, and FGR, significantly increases the likelihood of an abnormal CMA result.
... These findings are at odds with studies comparing neonatal anthropometric variables across genders: males tend to be larger than females during gestation and at birth, up to 12 months of age. 16,17 We believe the difference here has arisen due to the different populations studied; these studies looked at healthy neonates, while ours looked at sick ones. Thus, birth asphyxia itself served to confound the results. ...
Objective: To determine the frequency of acute kidney injury in neonates who develop asphyxia at delivery. Study Design: Cross-sectional study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Aug 2021 to Feb 2022. Methodology: This study was based on 69 patients diagnosed with birth asphyxia on the basis of APGAR score at 5 minutes. Patients underwent testing for serum creatinine levels at 24 hours post-delivery, as well as the monitoring of urine output, and acute kidney injury was classified according to the KDIGO classification, based on the increase in serum creatinine levels and urine output. Results: Acute kidney injury was observed in 12(17.4%) cases and 3(4.3%) neonates died. Lower gestational age at birth was associated with acute kidney injury (p=0.038), and acute kidney injury was associated with a higher chance for mortality (p<0.001). Additionally, male infants had a lower head circumference (p=0.001), a lower total body length (p<0.001) and a lower APGAR score at birth (p=0.004) when compared to females. However, they did not appear to have a higher risk for acute kidney injury (p=0.121). Conclusion: Acute kidney injury following the development of birth asphyxia is a common occurrence in our population efforts should be made to identify pregnancies at risk to mitigate this potentially devastating complication.
... With respect to the covariates, baseline models indicated that male sex was associated with larger HC (Galjaard et al., 2019), whereas the PI did not differ by sex. Low maternal SES was associated with overanxious symptoms, depression, conduct problems, and ADHD (but not separation anxiety or oppositional defiant disorder), in line with recent studies (Markham & Spencer, 2022;McLaughlin et al., 2011). ...
We compared individual differences in the Ponderal Index [(PI; weight(kg)/height(m3)] and head circumference (HC) in predicting internalizing and externalizing behaviors in childhood and adolescence in a cohort of ELBW survivors prospectively followed since birth. ELBW infants who were born thinner or with smaller HC showed greater PI or HC growth in the first 3 years. Latent difference score (LDS) models showed that compensatory HC growth in the first year, controlled for birth HC, predicted ADHD behaviors in adolescence in those born with smaller HC. LDS models also indicated that larger increases in the PI in the first year and smaller net decreases over 3 years predicted more internalizing behaviors in adolescence. Early growth patterns prioritizing weight over height may have negative effects on later mental health in ELBW survivors, consistent with developmental programming theories.
... It is also widely accepted that boys are slightly larger than girls following delivery at Term, hence the use of gender specific normative charts post-natally. An important recent paper by Galjaard et al. has studied head size in relation to the sex of the fetus [9]. Those authors reported nearly 28,000 fetuses from a low-risk Caucasian population and they showed that male fetuses have larger bi-parietal diameters and head circumferences when compared with female fetuses from 20gw. ...
Background
The primary aim of the study is to test the null hypothesis that there are no statistically significant differences in intracranial volumes between male and female fetuses. Furthermore, we have studied the symmetry of the cerebral hemispheres in the cohort of low-risk fetuses.
Methods
200 normal fetuses between 18 and 37 gestational weeks (gw) were included in the cohort and all had in utero MR, consisting of routine and 3D-volume imaging. The surfaces of the cerebral ventricles, brain and internal table of the skull were outlined manually and volume measurements were obtained of ventricles (VV), brain parenchyma (BPV), extraaxial CSF spaces (EAV) and the total intracranial volume (TICV). The changes in those values were studied over the gestational range, along with potential gender differences and asymmetries of the cerebral hemispheres.
Results
BPV and VV increased steadily from 18 to 37 gestational weeks, and as a result TICV also increased steadily over that period. TICV and BPV increased at a statistically significantly greater rate in male relative to female fetuses after 24gw. The greater VV in male fetuses was apparent earlier, but the rate of increase was similar for male and female fetuses. There was no difference between the genders in the left and right hemispherical volumes, and they remained symmetrical over the age range measured.
Conclusions
We have described the growth of the major intracranial compartments in fetuses between 18 and 37gw. We have shown a number of statistically different features between male and female fetuses, but we have not detected any asymmetry in volumes of the fetal cerebral hemispheres.
... Varias investigaciones han planteado que los recién nacidos del sexo masculino tienen más complicaciones perinatales comparados con las hembras y lo consideran como un factor de riesgo independiente, (9,10) se ha mostrado además, una diferencia en las curvas de crecimiento intrauterino y las posnatales, mayores en el sexo masculino, por lo que tienen mayor índice de masa corporal, lo que se ha asociado a una inadecuada adaptación nutricional posnatal, alteraciones del tránsito durante el trabajo de parto, mayor necesidad de instrumentaciones y evaluación de Apgar bajo. (11) Las diferencias entre ambos sexos referente a las enfermedades acaecidas en el periodo neonatal pueden repercutir en la salud posterior, varios estudios han tratado de explicar estas divergencias, pero cada una tiene diferentes factores implicados en su etiopatogenia, algunos de ellos pueden coincidir, aunque sus mecanismos no sean completamente similares. (12) El funcionamiento inadecuado de los principales procesos fisiológicos durante el embarazo por factores ambientales, puede impactar negativamente en la regulación de los mecanismos epigenéticos en la regulación de la expresión de los genes. ...
Revista Cubana de Pediatría. 2021;93(4):e1631 Esta obra está bajo una licencia https://creativecommons.org/licenses/by-nc/4.0/deed.es_ES 1 Artículo de revisión Epigenética, sexo masculino y enfermedades neonatales Epigenetic, male sex and neonatal disease RESUMEN Introducción: Estudios recientes han demostrado diferencias entre el sexo femenino y el masculino y su influencia en aspectos básicos de la biología, los cuales podrían influir a su vez, en la etiología y fisiopatología de enfermedades en la etapa neonatal. Es conocido que los cambios en la regulación epigenética por factores que afectan la exposición del cortisol fetal muestra efectos específicos según el tipo de sexo. Objetivo: Determinar la posible relación entre los cambios epigenéticos, el sexo masculino y las enfermedades neonatales. Métodos: Se realizó una búsqueda bibliográfica en Pubmed, Scielo, LILACS y en la plataforma Clínica Key entre los años 2017-2020, en idioma inglés y español. Se utilizaron diferentes palabras clave como diferencias sexuales, sexo masculino, epigenética y enfermedades neonatales. Análisis e integración de la información: En esta revisión se abordan aspectos como la epigenética en el desarrollo humano y su relación con el sexo, el papel de la placenta y su relación con el sexo fetal, las complicaciones perinatales y su relación con el sexo masculino. Además, se abordan las afecciones respiratorias, las afecciones neurológicas y otras de la etapa neonatal vinculadas con el sexo y la posible relación con los mecanismos epigenéticos. Conclusiones: El sexo masculino es un factor predisponente en la prevalencia de determinadas enfermedades neonatales. La epigenética puede estar involucrada en la aparición de muchas Revista Cubana de pediatría. 2021;93(4):e1631 Esta obra está bajo una licencia https://creativecommons.org/licenses/by-nc/4.0/deed.es_ES 2 enfermedades neonatales moduladas por el sexo por mecanismos aun no bien esclarecidos. Investigaciones futuras pudieran arrojar mayor conocimiento sobre la etiopatogenia de estas enfermedades y su forma de abordarlas. Palabras clave: diferencias sexuales; sexo masculino; epigenética y enfermedades neonatales. ABSTRACT Introduction: Recent studies have confirmed differences among the female and male sex and their influence in basic aspects of biology, which can also impact in the etiology and physiopathology of diseases in the neonatal stage. It is known that changes in the epigenetic regulation due to factors that affect the exposition to fetal cortisol show specific effects according to the type of sex. Objective: Determine the possible relation among the epigenetic changes, male sex and the neonatal diseases. Methods: It was carried out a bibliographic search in Pubmed, Scielo, LILACS and in the platform called Clínica Key, in the period 2017-2020, in English and Spanish languages. The following key words were used: sexual differences, male sex, epignetic and neonatal diseases. Analysis and Integration of the information: This review deals with aspects as epigenetic in human development and its relation with sex, the role of placenta and its relation with fetal sex, perinatal complications and their relation with male sex. In addition, the review also mentions respiratory conditions, neurologic conditions and others of the neonatal stage related with sex and the possible relation with epigenetic mechanisms. Conclusions: Male sex is a predisposing factor in the prevalence of certain neonatal diseases. Epigenetic can be involved in the onset of many neonatal diseases modulated by the sex due to mechanisms that are not clear yet. Future researches might show more knowledge on the etiopathogenesis of these disease and the way to approach them.
... The birth weight of male newborns is heavier than that of female newborns due to androgen action (46). In comparison with the female fetus, the birth weight of a male fetus is more subject to maternal nutritional status for the gender-different intrauterine physical adaptations (47). However, the interactive effect of maternal hemoglobin and neonatal gender on birth weight was only found in the middle range of maternal hemoglobin concentration. ...
Objective
Anemia is still an unfinished global health problem, and adverse birth weight outcomes have everlasting influences on the health of later life. However, the non-linear connections and breakpoints of maternal hemoglobin with birth weight outcomes are still needed to be further elucidated. We aimed to reveal the non-linear connections between maternal hemoglobin during the third trimester of pregnancy and birth weight, low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA) in full-term newborns and elucidate the breakpoints of the connections.
Methods
A total of 11,411 singletons, full-term, and live newborns, whose mothers conducted the examination of hemoglobin concentration before delivery, were included in this study. A generalized additive model was used to identify and visualize the non-linear connections between maternal hemoglobin and birth weight outcomes. Piecewise linear regression model was adopted to estimate the breakpoints of the connections and report the non-linear connections in detail.
Results
There were inverted “U”-shaped exposure–response connections between maternal hemoglobin concentration and birth weight and the risk of macrosomia. There was an increasing trend of the risk of LBW and a decreased trend of LGA with the increase in maternal hemoglobin concentration. The breakpoints of maternal hemoglobin for birth weight were 100 and 138 g/L, and those for SGA were 97 and 138 g/L. The breakpoints of maternal hemoglobin were 119 g/L for LBW, 105 g/L for macrosomia, and 106 g/L for LGA. When maternal hemoglobin concentration ranged from 100 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and birth weight significantly decreased by 2.58 g (95% CI: –3.33, –1.83). When maternal hemoglobin concentration ranged from 97 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of SGA significantly increased by 2% (95% CI: 1%, 3%). When maternal hemoglobin concentration was equal to or lower than 119 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of LBW significantly increased by 3% (95% CI: 0%, 5%). When maternal hemoglobin concentration was higher than the breakpoints, the risks of macrosomia (OR = 0.99, 95% CI: 0.98, 0.99) and LGA (OR = 0.99, 95% CI: 0.98, 1.00) declined as the increase of maternal hemoglobin concentration.
Conclusions
There were non-linear connections between maternal hemoglobin and birth weight outcomes, and there are breakpoints in the connections. Cost-effective interventions targeting pregnant women in the prevention of abnormal maternal hemoglobin concentration should be taken to reduce the incidence of adverse birth weight outcomes.
... 236important recent paper by Galjaard et al. has studied head size in relation to the sex of the 237 fetus[9]. Those authors reported nearly 28000 fetuses from a low-risk Caucasian population238 and they showed that male fetuses have larger bi-parietal diameters and head circumferences 239 when compared with female fetuses from 20gw. ...
Background: The primary aim of the study is to test the null hypothesis that there are no statistically significant differences in intracranial volumes between male and female fetuses. Furthermore, we have studied the symmetry of the cerebral hemispheres in the cohort of low-risk fetuses.
Methods: 200 normal fetuses between 18-37 gestational weeks (gw) were included in the cohort and all had in utero MR, consisting of routine and 3D-volume imaging. The surfaces of the cerebral ventricles, brain and internal table of the skull were outlined manually and volume measurements were obtained of ventricles (VV), brain parenchyma (BPV), extra-axial CSF spaces (EAV) and the total intracranial volume (TICV). The change in those values were studied over the gestational range, along with potential gender differences and asymmetries of the cerebral hemispheres.
Results: BPV and VV increased steadily from 18 to 37 gestational weeks, and as a result TICV also increased steadily over that period. TICV and BPV increased at a statistically significantly greater rate in male relative to female fetuses after 24gw. The greater VV in male fetuses was apparent earlier but the rate of increase was similar for male and female fetuses. There was no difference between the genders in the left and right hemispherical volumes, and they remained symmetrical over the age range measured.
Conclusions: We have described the growth of the major intracranial compartments in fetuses between 18-37gw. We have shown a number of statistically different features between male and female fetuses but we have not detected any asymmetry in volumes of the fetal cerebral hemispheres.
... Sex-specific nomograms for the pediatric population exist and are routinely used [4,5]. However, only recently (2019), Galjaard et al. [6] published sex-specific longitudinal fetal brain growth curves, based on the measurements of over 27,000 fetuses on ultrasound, allowing integration with neonatal and pediatric WHO sex-specific head growth curves [5]. They showed that the head circumference (HC) and biparietal diameter (BPD) are considerably larger in males compared to females from 20 weeks of gestation onwards (p < 0.001) [6]. ...
... However, only recently (2019), Galjaard et al. [6] published sex-specific longitudinal fetal brain growth curves, based on the measurements of over 27,000 fetuses on ultrasound, allowing integration with neonatal and pediatric WHO sex-specific head growth curves [5]. They showed that the head circumference (HC) and biparietal diameter (BPD) are considerably larger in males compared to females from 20 weeks of gestation onwards (p < 0.001) [6]. In recent years, the use of MRI in the assessment of the fetal brain has been investigated and data on the fetal central nervous system (CNS) is accumulating [7][8][9]. ...
... The differences among sexes from early fetal period to adulthood are well documented in the literature. Our study further delineates these differences and is in accordance with previous publications [6,[14][15][16][17][18][19]. We have found that the biparietal diameter and the occipitofrontal diameter were significantly larger in male fetuses on two-dimensional MRI (p < 0.001). ...
Purpose
Fetal growth assessment is a key component of prenatal care. Sex-specific fetal brain nomograms on ultrasound are available and are clinically used. In recent years, the use of fetal MRI has been increasing; however, there are no sex-specific fetal CNS nomograms on MRI. The study aimed to assess the differences in fetal brain biometry and growth trajectories and to create population-based standards of the fetal brain on MRI.
Methods
In this cross-sectional study, brain structures of singleton fetuses with normal brain MRI scans were analyzed: biparietal diameter, occipitofrontal diameter, trans-cerebellar diameter, and the corpus callosum were measured and converted into centiles. Sex-specific nomograms were created.
Results
A total of 3848 MRI scans were performed in one tertiary medical center between 2011 and 2019; of them, 598 fetuses met the inclusion criteria, 300 males and 298 females between 28- and 37-weeks’ gestation. Males had significantly larger occipitofrontal diameter than females (median 75%, IQR 54–88%; median 61%, IQR 40–77%) and biparietal diameter (median 63%, IQR 42–82%; median 50%, IQR 25–73%), respectively (p < 0.001). The cerebellum had the greatest growth rate, with a 1.5-fold increase in diameter between 28 and 37 weeks’ gestation, with no measurement difference between the sexes (p = 0.239). No significant difference was found in the corpus callosum (p = 0.074).
Conclusion
Measuring both sexes on the same nomograms may result in over-estimation of male fetuses and under-estimation of females. We provide fetal sex-specific nomograms on two-dimensional MRI.
... Sexual dimorphism in the context of brain structure, function and chemistry has been consistently reported. Total and regional volume, for example, differs between males and females, including during fetal development (Ritchie et al., 2018;Galjaard et al., 2019). Moreover, males present higher connectivity between different regions, while females demonstrate higher connectivity within regions (Gur and Gur, 2016). ...
Neurodevelopmental disorders differ considerably between males and females, and fetal brain development is one of the most critical periods to determine risk for these disorders. Transcriptomic studies comparing male and female fetal brain have demonstrated that the highest difference in gene expression occurs in sex chromosomes, but several autossomal genes also demonstrate a slight difference that has not been yet explored. In order to investigate biological pathways underlying fetal brain sex differences, we applied medicine network principles using integrative methods such as co-expression networks (CEMiTool) and regulatory networks (netZoo). The pattern of gene expression from genes in the same pathway tend to reflect biologically relevant phenomena. In this study, network analysis of fetal brain expression reveals regulatory differences between males and females. Integrating two different bioinformatics tools, our results suggest that biological processes such as cell cycle, cell differentiation, energy metabolism and extracellular matrix organization are consistently sex-biased. MSET analysis demonstrates that these differences are relevant to neurodevelopmental disorders, including autism.
