WHO/HRP Project A65097 
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.