据2月10日刊JAMA上的一则研究披露，诸如孕妇高血压和高血细胞比容（即血液中由红血球所组成的比例）等因素与胎儿在头三个月中的生长受限可能性增加有关，而胎儿生长受限与早产和出生体重低等风险增加有关。
文章的作者写道：“人类生长和发育速度最快的时期是在母体内的头三个月。在这段时间内，胎儿的主要器官的发育已经完成。母体的头三个月中如果接触到不良的影响可能会对胎儿及其出生之后的健康带来永久性的后果。但人们不知道，母体的生理特征和生活习惯对胎儿头三个月的适应及其出生后会有怎样的影响。”
Erasmus Medical Center, Rotterdam, the Netherlands的Dennis O. Mook-Kanamori, M.D., M.Sc.及其同僚对1631位母亲的母体生理特点和生活方式习惯与头三个月的胎儿生长之间的关系以及胎儿头三个月的生长限制与不良出生后果及出生后直到2岁时的加速生长之间的关系进行了研究。这些母亲是在2001年和2005年之间进入该项研究的。头三个月胎儿的生长是以在妊娠的10周又0天至13周又6天之间通过超声波所测得的胎儿顶臀长度来衡量的。
研究人员发现，母亲在怀孕时的年龄与头三个月的胎儿顶臀长度之间有着正相关关系，而较高的舒张压和较高的血球容积则与较短的胎儿顶臀长度有关。与那些不抽烟及最佳化服用叶酸补充剂的母亲相比， 那些既抽烟又不服用叶酸补充剂的母亲的胎儿的顶臀长度较短。
研究人员写道：“与正常的头三个月胎儿生长相比，那些头三个月生长受到限制的胎儿与其发生早产（4.0% vs. 7.2%）、低出生体重（3.5% vs. 7.5%）及在出生时体形与孕期相称的体形相比较小（4.0% vs. 10.6%）等风险增加有关。”他们还发现，胎儿头三个月的较短的顶臀长度与幼儿早期的生长速度加快之间有关系。（生物谷Bioon.com）
生物谷推荐原始出处：
JAMA. 2010;303(6):527-534.
Risk Factors and Outcomes Associated With First-Trimester Fetal Growth Restriction
Dennis O. Mook-Kanamori, MD, MSc; Eric A. P. Steegers, MD, PhD; Paul H. Eilers, PhD; Hein Raat, MD, PhD; Albert Hofman, MD, PhD; Vincent W. V. Jaddoe, MD, PhD
Context Adverse environmental exposures lead to developmental adaptations in fetal life. The influences of maternal physical characteristics and lifestyle habits on first-trimester fetal adaptations and the postnatal consequences are not known.
Objective To determine the risk factors and outcomes associated with first-trimester growth restriction.
Design, Setting, and Participants Prospective evaluation of the associations of maternal physical characteristics and lifestyle habits with first-trimester fetal crown to rump length in 1631 mothers with a known and reliable first day of their last menstrual period and a regular menstrual cycle. Subsequently, we assessed the associations of first-trimester fetal growth restriction with the risks of adverse birth outcomes and postnatal growth acceleration until the age of 2 years. The study was based in Rotterdam, the Netherlands. Mothers were enrolled between 2001 and 2005.
Main Outcome Measures First-trimester fetal growth was measured as fetal crown to rump length by ultrasound between the gestational age of 10 weeks 0 days and 13 weeks 6 days. Main birth outcomes were preterm birth (gestational age <37 weeks), low birth weight (<2500 g), and small size for gestational age (lowest fifth birth centile). Postnatal growth was measured until the age of 2 years.
Results In the multivariate analysis, maternal age was positively associated with first-trimester fetal crown to rump length (difference per maternal year of age, 0.79 mm; 95% confidence interval [CI], 0.41 to 1.18 per standard deviation score increase). Higher diastolic blood pressure and higher hematocrit levels were associated with a shorter crown to rump length (differences, –0.40 mm; 95% CI, –0.74 to –0.06 and –0.52 mm; 95% CI, –0.90 to –0.14 per standard deviation increase, respectively). Compared with mothers who were nonsmokers and optimal users of folic acid supplements, those who both smoked and did not use folic acid supplements had shorter fetal crown to rump lengths (difference, –3.84 mm; 95% CI, –5.71 to –1.98). Compared with normal first-trimester fetal growth, first-trimester growth restriction was associated with increased risks of preterm birth (4.0% vs 7.2%; adjusted odds ratio [OR], 2.12; 95% CI, 1.24 to 3.61), low birth weight (3.5% vs 7.5%; adjusted OR, 2.42; 95% CI, 1.41 to 4.16), and small size for gestational age at birth (4.0% vs 10.6%; adjusted OR, 2.64; 95% CI, 1.64 to 4.25). Each standard deviation decrease in first-trimester fetal crown to rump length was associated with a postnatal growth acceleration until the age of 2 years (standard deviation score increase, 0.139 per 2 years; 95% CI, 0.097 to 0.181).
Conclusions Maternal physical characteristics and lifestyle habits were independently associated with early fetal growth. First-trimester fetal growth restriction was associated with an increased risk of adverse birth outcomes and growth acceleration in early childhood.
