supplementary fetal growth curves - john archieautopsy.jarchie.com/fetal_growth_curves.pdf ·...
Post on 06-Feb-2018
217 Views
Preview:
TRANSCRIPT
Supplementary Fetal Growth Curves
John G. Archie, Julianne S. Collins, and Robert Roger Lebel
June 19, 2006
The following growth curves are described in themanuscript entitled “Quantitative Standards for Fe-tal and Neonatal Autopsy.” While the tables in themanuscript are better suited for displaying these nu-merical data, some may still prefer charts, hence thereason for this document.
Most of these curves are constructed from regres-sions on data from multiple sources, and the remain-ing curves are derived from a single source. Allsources studied non-macerated tissue examined at au-topsy and excluded fetuses with obvious malforma-tions. (The one exception to this rule is hand lengthat later ages, which incorporates data from normallive borns.) Thus, these standards are designed toshow whether various measurements obtained at au-topsy are normal when compared to other seeminglynormal fetuses examined at autopsy.
The dotted, dash-dotted, and dashed lines corre-spond to plus or minus 1.00, 1.28, and 1.64 stan-dard deviations, respectively. Assuming the data arenormally distributed, these lines also correspond with16–84th, 10–90th, and 5–95th percentiles, respectively.Note that standard deviation data is not available forphiltrum length, chest circumference, abdominal cir-
cumference, small intestine length, and large intestinelength.
Contents
Weight Measurements 2
Body Weight (12–44 Weeks) . . . . . . . . . . 2Body Weight (12–24 Weeks) . . . . . . . . . . 3Brain Weight (12–44 Weeks) . . . . . . . . . 4Brain Weight (12–24 Weeks) . . . . . . . . . 5Thymus Weight (12–44 Weeks) . . . . . . . . 6Thymus Weight (12–24 Weeks) . . . . . . . . 7Lung Weight (12–44 Weeks) . . . . . . . . . . 8Lung Weight (12–24 Weeks) . . . . . . . . . . 9Heart Weight (12–44 Weeks) . . . . . . . . . 10Heart Weight (12–24 Weeks) . . . . . . . . . 11Liver Weight (12–44 Weeks) . . . . . . . . . . 12Liver Weight (12–24 Weeks) . . . . . . . . . . 13Spleen Weight (12–44 Weeks) . . . . . . . . . 14Spleen Weight (12–24 Weeks) . . . . . . . . . 15Adrenal Weight (12–44 Weeks) . . . . . . . . 16Adrenal Weight (12–24 Weeks) . . . . . . . . 17Pancreas Weight (20–42 Weeks) . . . . . . . . 18
Kidney Weight (12–44 Weeks) . . . . . . . . . 20Kidney Weight (12–24 Weeks) . . . . . . . . . 21
Linear Measurements 22
Crown-Heel Length (12–42 Weeks) . . . . . . 22Crown-Heel Length (12–24 Weeks) . . . . . . 23Crown-Rump Length (12–42 Weeks) . . . . . 24Crown-Rump Length (12–24 Weeks) . . . . . 25Head Circumference (12–42 Weeks) . . . . . . 26Biparietal Diameter (12–42 Weeks) . . . . . . 27Outer Canthal Distance (12–42 Weeks) . . . 28Inner Canthal Distance (12–42 Weeks) . . . . 29Philtrum Length (13–26 Weeks) . . . . . . . 30Chest Circumference (13–40 Weeks) . . . . . 31Inter-Nipple Distance (12–42 Weeks) . . . . . 32Inter-Nipple Distance (12–24 Weeks) . . . . . 33Abdominal Circumference (13–26 Weeks) . . 34Hand Length (13–42 Weeks) . . . . . . . . . . 35Foot Length (12–42 Weeks) . . . . . . . . . . 36Foot Length (12–24 Weeks) . . . . . . . . . . 37
Internal Measurements 38
Small Intestine Length (12–25 Weeks) . . . . 38Large Intestine Length (12–25 Weeks) . . . . 39
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
040
080
012
0018
0024
0030
0036
0042
0048
00 Body Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991)
2
12 13 14 15 16 17 18 19 20 21 22 23 24
050
100
200
300
400
500
600
700
Body Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), and Wigglesworth and Singer (1991)
3
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
040
8012
016
020
024
028
032
036
040
044
048
052
0 Brain Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
4
12 13 14 15 16 17 18 19 20 21 22 23 24
05
1525
3545
5565
7585
9510
5Brain Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
5
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
01
23
45
67
89
1011
1213
1415
1617
Thymus Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
6
12 13 14 15 16 17 18 19 20 21 22 23 24
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2.0
2.2
2.4 Thymus Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
7
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
05
1015
2025
3035
4045
5055
6065
7075
8085
Lung Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
8
12 13 14 15 16 17 18 19 20 21 22 23 24
01
23
45
67
89
1113
1517
1921
23Lung Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
9
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
02
46
810
1214
1618
2022
2426
2830
3234
Heart Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
10
12 13 14 15 16 17 18 19 20 21 22 23 24
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
Heart Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
11
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
020
4060
8010
012
014
016
018
020
022
0Liver Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
12
12 13 14 15 16 17 18 19 20 21 22 23 24
02
46
810
1418
2226
3034
38Liver Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
13
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
01
23
45
67
89
1012
1416
18Spleen Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
14
12 13 14 15 16 17 18 19 20 21 22 23 24
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
1.1
1.2
1.3
1.4
1.5 Spleen Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
15
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
01
23
45
67
89
1011
1213
1415
Adrenals Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
16
12 13 14 15 16 17 18 19 20 21 22 23 24
0.0
0.4
0.8
1.2
1.6
2.0
2.4
2.8
3.2
Adrenals Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
17
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
Pancreas Weight (20−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Wigglesworth and Singer (1991)
18
This page is intentionally left blank.
19
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
02
46
812
1620
2428
3236
4044
Kidney Weight (12−44 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
20
12 13 14 15 16 17 18 19 20 21 22 23 24
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Kidney Weight (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Wei
ght (
g)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Gruenwald and Minh (1960), Hansen et al. (2003), Larroche (1977), and Wigglesworth and Singer (1991)
21
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
050
100
150
200
250
300
350
400
450
500
550
600
Crown−Heel Length (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)
22
12 13 14 15 16 17 18 19 20 21 22 23 24
020
4060
8012
016
020
024
028
032
0Crown−Heel Length (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)
23
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
040
8012
016
020
024
028
032
036
040
0Crown−Rump Length (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)
24
12 13 14 15 16 17 18 19 20 21 22 23 24
020
4060
8010
012
014
016
018
020
022
024
0 Crown−Rump Length (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Cussen et al. (1990), Hansen et al. (2003), and Wigglesworth and Singer (1991)
25
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
020
6010
014
018
022
026
030
034
038
0Head Circumference (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
26
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
05
1525
3545
5565
7585
9510
5Biparietal Diameter (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
27
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
05
1015
2025
3035
4045
5055
6065
7075
Outer Canthal Distance (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
28
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
12
34
56
78
911
1315
1719
2123
25Inner Canthal Distance (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
29
13 14 15 16 17 18 19 20 21 22 23 24 25 26
0.8
1.2
1.6
2.0
2.4
2.8
3.2
3.6
4.0
4.4
4.8
5.2
5.6
6.0
6.4
6.8 Philtrum Length (13−26 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
Source: Chambers et al. (1993)
30
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
020
4060
8012
016
020
024
028
032
0Chest Circumference (13−40 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
Sources: Bhat et al. (1989) and Chambers et al. (1993)
31
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
05
1020
3040
5060
7080
90Inter−Nipple Distance (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
32
12 13 14 15 16 17 18 19 20 21 22 23 24
02
46
812
1620
2428
3236
4044
48Inter−Nipple Distance (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Source: Guihard-Costa et al. (2003)
33
13 14 15 16 17 18 19 20 21 22 23 24 25 26
010
3050
7090
110
130
150
170
Abdominal Circumference (13−26 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
Source: Chambers et al. (1993)
34
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
05
1015
2025
3035
4045
5055
6065
7075
Hand Length (13−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Chambers et al. (1993) and Madhulika et al. (1989)
35
11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43
05
1020
3040
5060
7080
90Foot Length (12−42 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991)
36
12 13 14 15 16 17 18 19 20 21 22 23 24
02
46
812
1620
2428
3236
4044
48Foot Length (12−24 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
mm
)
1.00 SD; 16−84th percentile1.28 SD; 10−90th percentile1.64 SD; 5−95th percentile
Sources: Hansen et al. (2003) and Wigglesworth and Singer (1991)
37
12 13 14 15 16 17 18 19 20 21 22 23 24 25
010
2030
4050
6070
8090
100
110
120
130
Small Intestine Length (12−25 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
cm)
Source: FitzSimmons et al. (1988)
38
12 13 14 15 16 17 18 19 20 21 22 23 24 25
02
46
810
1214
1618
2022
2426
Large Intestine Length (12−25 Weeks)
Postmenstrual Gestational Age (Weeks)
Leng
th (
cm)
Source: FitzSimmons et al. (1988)
39
References
Bhat, G. J., K. Mukelabai, G. N. Shastri, and C. Tamina (1989,Jun). Anthropometric parameters of Zambian infants at birth.J Trop Pediatr 35 (3), 100–104.
Chambers, H. M., S. Knowles, A. Staples, M. Tamblyn, and E. A.Haan (1993, Apr). Anthropometric measurements in the secondtrimester fetus. Early Hum Dev 33 (1), 45–59.
Cussen, L., J. Scurry, G. Mitropoulos, C. McTigue, and J. Gross(1990, Apr). Mean organ weights of an Australian population offetuses and infants. J Paediatr Child Health 26 (2), 101–103.
FitzSimmons, J., A. Chinn, and T. H. Shepard (1988, Nov–Dec).Normal length of the human fetal gastrointestinal tract. Pediatr
Pathol 8 (6), 633–641.
Gruenwald, P. and H. N. Minh (1960, Sep). Evaluation of bodyand organ weights in perinatal pathology. I. Normal standardsderived from autopsies. Am J Clin Pathol 34 (3), 247–253.
Guihard-Costa, A.-M., F. Menez, and A. L. Delezoide (2003, Sep–Oct). Standards for dysmorphological diagnosis in human fe-tuses. Pediatr Dev Pathol 6 (5), 427–434.
Hansen, K., C. J. Sung, C. Huang, H. Pinar, D. B. Singer, and C. E.Oyer (2003, Mar–Apr). Reference values for second trimesterfetal and neonatal organ weights and measurements. Pediatr
Dev Pathol 6 (2), 160–167.
Larroche, J.-C. (1977). Developmental Pathology of the Neonate.London: Excerpta Medica.
Madhulika, S. K. Kabra, V. Barar, A. Purohit, S. Saxena,U. Sharma, and R. K. Bansal (1989, Jul). Upper and lowerlimb standards in newborn. Indian Pediatr 26 (7), 667–670.
Wigglesworth, J. S. and D. B. Singer (1991). Textbook of Fetal and
Perinatal Pathology. Amsterdam: Blackwell Publishers.
40
top related