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The GROW customised fetal growth model : background, principles, validation and application
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Francis, Andre (2021) The GROW customised fetal growth model : background, principles, validation and application. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3856169
Abstract
First, I present the background and need that led to this work. While the assessment of fetal growth is an essential part of clinical care, there were substantial limitations in traditional models’ growth charts in clinical practice; namely, their ‘one size fits all’ approach, with no allowance for individual variation.
I next describe the innovative concepts applied to address this problem, and outline the principles that led to the ‘gestation-related optimal weight’ (GROW) standard: adjustment for individual variation, optimisation to exclude pathological influences, and the application of a fetal rather than a birthweight standard to delineate normal growth. Using these principles, GROW can produce personal antenatal charts, centred on each baby’s individual growth potential.
I then selected eight publications to illustrate the validation and application of these principles, highlighting for each: objective, my contribution, key findings and impact.
The first three studies dealt with validation of the GROW principle through comparison with various population based standards, and show that the customised approach performs better at confirming normal growth and identifying growth-restriction-related pregnancy outcomes.
The next five studies present various applications of this standard to enhance our understanding of risk factors for fetal growth restriction, stillbirth, perinatal morbidity and cerebral palsy. A key finding (publication 7) was that risk can be reduced by improved antenatal recognition of fetal growth problems, helping to stimulate and focus health service initiatives on prevention. The series culminates in a study describing the results of implementation of a surveillance programme including GROW charts across three English health service regions, leading to a significant reduction in stillbirth rates.
I believe my contribution to these studies and others over more than 25 years has supported the development and international recognition of the GROW standard.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | ||||
Library of Congress Subject Headings (LCSH): | Fetus -- Growth, Fetus -- Growth -- Charts, diagrams, etc., Birth weight -- Standards -- Evaluation | ||||
Official Date: | October 2021 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Format of File: | |||||
Extent: | 49 leaves : illustrations | ||||
Language: | eng |
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