Imaging with ultrasound is common in obstetric practice. Several laboratory animal studies have shown retardation in fetal growth after experimental ultrasound exposure. This investigation was conducted to determine whether human fetuses exposed to diagnostic ultrasound (sonography) have a greater risk of growth retardation than fetuses not so exposed. This retrospective cohort study compares the birth weights of 1598 exposed and 944 unexposed single live births at the Johns Hopkins Hospital in Baltimore, Maryland during calendar year 1981. Confounding variables, defined as those associated with both exposure status and birth weight outcome, were included in multivariable analysis. Both exposure to more than one ultrasound procedure and first exposure during the third trimester were associated with a reduction in birth weight. However, the most consistent effect associated with birth weight appeared to be the indication for an ultrasound examination. The relationship of ultrasound exposure and reduced birth weight appeared to be due to shared common risk factors, which lead to both exposure and a reduction in birth weight.

A compilation of reports of biological effects and related ultrasound exposure levels can be useful in the identification of trends in effects data that may be developing in the literature. The exposures in the experiments reviewed were at frequencies used in medicine. For short (10 minutes or less) continuous wave exposure, with the exception of behavioral effects where variable results have been observed, this tabulation did not identify any in vivo or in vitro effects at spatial peak, temporal average (SPTA) intensities less than 100 mW/cm 2 . However, a number of effects using pulsed sources with SPTA intensities under this level have been reported. There are several frequently recurring topics in recent reports which include developmental effects and microstructure changes at the cellular level. In addition to animal investigations, there are some limited human epidemiological studies reporting an association between medical ultrasound exposure in utero and developmental effects. Although sufficient research has not been completed to draw conclusions, the findings deserve further investigation. A systematic pattern of directed research on a large scale is not apparent. The available data consist of many scattered studies conducted by individual investigators and groups throughout the world.