Low Birth-Weight Risk Be...( l and eliminated from consideration all...)

l and eliminated from consideration all with complicating factors, such as illness in the mother or fetal abnormalities. They also excluded women who were uncertain about their conception dates or who had not received their first prenatal care until the second or third trimester. The analysis was then focused on the remaining 4,229 pregnancies.

Electronic calipers were used with each ultrasound image to measure the crown-rump length (the entire head and body, minus the legs), and each pregnancy was followed through to delivery. In a statistically significant number of cases, the researchers report, embryos (the first eight weeks of pregnancy) and fetuses (beyond eight weeks) that were small for their age during the first trimester were twice as likely to be born prematurely and three times more likely to fall into the smallest 5 percent of babies.

"A significant proportion of low birth-weight and extremely premature birth seems to be determined at a very early stage," Smith comments. "Obstetricians can't generally predict extremely premature delivery and when a baby is born prematurely there is often no obvious cause. Our study suggests that inadequate transfer of nutrients to the growing fetus may explain some of these cases."

The finding that low birth weight and premature birth is determined in the first trimester, Cornell's Smith says, might indicate a benefit that could result from even earlier intervention. He suggests better nutrition and health care for women of child-bearing age who are likely to become pregnant. Waiting until after conception to prepare for motherhood might be waiting too long, he says.

Attempts by mothers to eat heartily in the first trimester might be futile, Cornell's Smith says, pointing to a maternal paradox: "Mothers don't wish to eat much in the early weeks. One theory is that a mother's nausea protects her developing embryo from natural toxins in food," he says. "And this may be a way of reminding mothers t
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Contact: Roger Segelken
hrs2@cornell.edu
607-255-9736
Cornell University News Service
16-Dec-1998

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