A Dynamical Systems Model of Intrauterine Fetal Growth

Mohammad T Freigoun, Daniel E Rivera, Penghong Guo, Emily E Hohman, Alison D Gernand, Danielle Symons Downs, Jennifer S Savage, Mohammad T Freigoun, Daniel E Rivera, Penghong Guo, Emily E Hohman, Alison D Gernand, Danielle Symons Downs, Jennifer S Savage

Abstract

The underlying mechanisms for how maternal perinatal obesity and intrauterine environment influence fetal development are not well understood and thus require further understanding. In this paper, energy balance concepts are used to develop a comprehensive dynamical systems model for fetal growth that illustrates how maternal factors (energy intake and physical activity) influence fetal weight and related components (fat mass, fat-free mass, and placental volume) over time. The model is estimated from intensive measurements of fetal weight and placental volume obtained as part of Healthy Mom Zone (HMZ), a novel intervention for managing gestational weight gain in obese/overweight women. The overall result of the modeling procedure is a parsimonious system of equations that reliably predicts fetal weight gain and birth weight based on a sensible number of assessments. This model can inform clinical care recommendations as well as how adaptive interventions, such as HMZ, can influence fetal growth and birth outcomes.

Keywords: Biomedical Modeling; Optimization; System Identification.

Figures

Figure A1:
Figure A1:
Time-domain response (fetal weight, placental volume, and fetal % body fat) with energy intake and physical activity for a representative HMZ intervention participant (participant C) (simulation starts at the day of first ultrasound measurement and ends at birth).
Figure A2:
Figure A2:
Time-domain response (fetal weight, placental volume, and fetal % body fat) with energy intake and physical activity for a representative HMZ control participant (participant D) (simulation starts at the day of first ultrasound measurement and ends at birth).
Figure A3:
Figure A3:
Fetal fat mass and fat-free mass growth profiles over time for representative HMZ participants (participants C and D).
Figure A4:
Figure A4:
Time-varying τf and ef for representative HMZ participants (participants C and D).
Figure A5:
Figure A5:
Time-varying gain and the establishment of positive fetal energy balance for representative HMZ participants (see equation (23)).
Figure A6:
Figure A6:
Predicted time-domain profile of fetal energy intake If(t) for representative HMZ participants (see equation (15)).
Figure 1:
Figure 1:
Representative placental volume growth profile.
Figure 2:
Figure 2:
Example of an ultrasound report for establishing estimated measurements of Estimated Fetal Weight (EFW), Estimated Placental Volume (EPV), and fetal body composition of an HMZ participant.
Figure 3:
Figure 3:
Time-domain response (fetal weight, placental volume, and fetal % body fat) with energy intake and physical activity for a representative HMZ intervention participant (participant A) (simulation starts at the day of first ultrasound measurement and ends at birth).
Figure 4:
Figure 4:
Time-domain response (fetal weight, placental volume, and fetal % body fat) with energy intake and physical activity for a representative HMZ control participant (participant B) (simulation starts at the day of first ultrasound measurement and ends at birth).
Figure 5:
Figure 5:
Fetal fat mass and fat-free mass growth profiles over time for representative HMZ participants (participants A and B).
Figure 6:
Figure 6:
Time-varying τf and ef for representative HMZ participants (participants A and B).

Source: PubMed

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