Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D
BACKGROUND Previous research suggests that vitamin D deficiency during pregnancy may be associated with suboptimal fetal growth, but direct evidence is lacking. Our objectives were 1) to develop a method for measurement of the fetal sphenoidal fontanelle area (FA) and femur volume (FV) using 3D ultr...
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| Format: | Thesis |
| Language: | English |
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2012
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| _version_ | 1826297642184867840 |
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| author | Ioannou, C Dr Christos Ioannou |
| author2 | Papageorghiou, A |
| author_facet | Papageorghiou, A Ioannou, C Dr Christos Ioannou |
| author_sort | Ioannou, C |
| collection | OXFORD |
| description | BACKGROUND Previous research suggests that vitamin D deficiency during pregnancy may be associated with suboptimal fetal growth, but direct evidence is lacking. Our objectives were 1) to develop a method for measurement of the fetal sphenoidal fontanelle area (FA) and femur volume (FV) using 3D ultrasound; 2) to create normal charts for FA and FV; and 3) to correlate FA and FV with maternal vitamin D concentration. METHODS FA measurement in 3D was evaluated in vitro and in vivo. Different segmentation methods for FV measurement were explored. A novel FV method was described which consists of three linear measurements and a volume equation; this was validated in vitro and also by comparing FV measured sonographically to the true volume assessed by computed tomography (CT), in 6 cases following pregnancy termination. A cohort of 868 uncomplicated pregnancies was selected on the basis of strict inclusion criteria; participants underwent serial ultrasound scans for FV and multilevel modeling was used for the creation of a “prescriptive” FV chart. Finally, a different cohort of 357 healthy pregnant women had serum vitamin D levels and FV ultrasound at 34 weeks gestation and dual emission x-ray absorptiometry (DEXA) of their neonates in order to investigate the prenatal determinants of fetal bone mass. RESULTS FA measurement was accurate in vitro, but unreliable in vivo and was therefore abandoned. A novel FV method had excellent agreement with CT and superior repeatability compared with segmentation-based methods. A normal FV chart was created and the regression equations for the median and percentile values were presented. Vitamin D demonstrated a significant correlation with FV. CONCLUSIONS FV is a reliable sonographic marker of skeletal growth. Maternal vitamin D deficiency is associated with reduced FV. This finding has public health implications as reduced bone mass may increase the lifetime risk of osteoporosis, through fetal programming. |
| first_indexed | 2024-03-07T04:34:46Z |
| format | Thesis |
| id | oxford-uuid:cf8d5030-a117-4548-921c-e802c873c40f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:34:46Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:cf8d5030-a117-4548-921c-e802c873c40f2022-03-27T07:43:25ZFetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin DThesishttp://purl.org/coar/resource_type/c_db06uuid:cf8d5030-a117-4548-921c-e802c873c40fEpidemiologyObstetricsMedical SciencesEnglishOxford University Research Archive - Valet2012Ioannou, CDr Christos IoannouPapageorghiou, AJavaid, KBACKGROUND Previous research suggests that vitamin D deficiency during pregnancy may be associated with suboptimal fetal growth, but direct evidence is lacking. Our objectives were 1) to develop a method for measurement of the fetal sphenoidal fontanelle area (FA) and femur volume (FV) using 3D ultrasound; 2) to create normal charts for FA and FV; and 3) to correlate FA and FV with maternal vitamin D concentration. METHODS FA measurement in 3D was evaluated in vitro and in vivo. Different segmentation methods for FV measurement were explored. A novel FV method was described which consists of three linear measurements and a volume equation; this was validated in vitro and also by comparing FV measured sonographically to the true volume assessed by computed tomography (CT), in 6 cases following pregnancy termination. A cohort of 868 uncomplicated pregnancies was selected on the basis of strict inclusion criteria; participants underwent serial ultrasound scans for FV and multilevel modeling was used for the creation of a “prescriptive” FV chart. Finally, a different cohort of 357 healthy pregnant women had serum vitamin D levels and FV ultrasound at 34 weeks gestation and dual emission x-ray absorptiometry (DEXA) of their neonates in order to investigate the prenatal determinants of fetal bone mass. RESULTS FA measurement was accurate in vitro, but unreliable in vivo and was therefore abandoned. A novel FV method had excellent agreement with CT and superior repeatability compared with segmentation-based methods. A normal FV chart was created and the regression equations for the median and percentile values were presented. Vitamin D demonstrated a significant correlation with FV. CONCLUSIONS FV is a reliable sonographic marker of skeletal growth. Maternal vitamin D deficiency is associated with reduced FV. This finding has public health implications as reduced bone mass may increase the lifetime risk of osteoporosis, through fetal programming. |
| spellingShingle | Epidemiology Obstetrics Medical Sciences Ioannou, C Dr Christos Ioannou Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title | Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title_full | Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title_fullStr | Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title_full_unstemmed | Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title_short | Fetal skeletal imaging using 3D ultrasound and the impact of maternal vitamin D |
| title_sort | fetal skeletal imaging using 3d ultrasound and the impact of maternal vitamin d |
| topic | Epidemiology Obstetrics Medical Sciences |
| work_keys_str_mv | AT ioannouc fetalskeletalimagingusing3dultrasoundandtheimpactofmaternalvitamind AT drchristosioannou fetalskeletalimagingusing3dultrasoundandtheimpactofmaternalvitamind |