摘要
目的调查适于胎龄儿(AGA)生长速度的减慢是否与胎盘功能不全相关,并确定生长速度减慢程度的临床阈值。方法孕中期胎儿形态检查正常的18岁以上的单胎妊娠女性,在第28周和36周,分别采用超声检查估计胎儿体重(EFW)和腹围(AC),第36周时检测脑-胎盘比(CPR),新生儿出生后进行脐动脉血气分析并测量体脂百分含量(F%)。考察EFW和AC的相对生长速度与CPR、脐动脉pH<7.10和F%<10%的发生率之间的相关性。结果共纳入308例符合入排标准的产妇。EFW(R^(2)=0.021,P=0.014)和AC(R^(2)=0.017,P=0.026)的生长速度均与36周CPR MoM显着相关。EFW生长速度每降低1个百分位数,36周时发生低CPR的几率增加2.4%。EFW生长速度小于-30百分位数的胎儿中,低CPR的发生率更高,相对危险度(RR)为2.8。EFW生长速度每降低1个百分位数,低F%的发生率增加3.3%;AC生长速度每降低1个百分位数,低F%的发生率增加3.6%。AC生长速度小于-30百分位数的新生儿低F%发生率更高,RR为8.1。结论在妊娠晚期表现出低生长速度的AGA新生儿在产前表现出胎盘功能不全的特征,需要加强监护和管理。
Objective To investigate whether reduced growth rate in appropriate-for-gestational-age(AGA)is related to placental dysfunction and to determine the clinical threshold of the degree of growth rate decrease.Methods Estimated fetal weight(EFW)and abdominal circumference(AC)were estimated by ultrasound at week 28 and 36,respectively,and brain-placental ratio(CPR)was measured at week 36.Umbilical artery blood gas analysis and body fat percentage(F%)were performed after birth.The correlation between the relative growth rates of EFW and AC and the incidence of CPR,incidence of umbilical artery PH<7.10 and F%<10%was investigated.Results A total of 308 women were included.Growth speed of EFW(R^(2)=0.021,P=0.014)and AC(R^(2)=0.017,P=0.026)were significantly correlated with 36-week CPR MoM.For every 1 percentile decrease in EFW growth,the incidence of low CPR at week 36 increased by 2.4%.The incidence of low CPR was higher in fetuses whose EFW growth rate was less than-30 centiles,with a relative risk(RR)of 2.8.For every 1 centile decrease in EFW growth rate,the incidence of low F%increased by 3.3%.For every 1 centile decrease in AC growth rate,the incidence of low F%increased by 3.6%.The incidence of low F%in newborns with AC growth rate less than-30 centiles was higher,RR was 8.1.Conclusion AGA newborns with low growth rate in the third trimester of pregnancy show signs of placental insufficiency prenatal,requiring intensive monitoring and management.
作者
焦蕊丽
乔晓林
张慧
JIAO Rui-li;QIAO Xiao-lin;ZHANG Hui(Obstetrics and Gynecology Department,Beijing Chaoyang maternal and Child Health Hospital,Beijing 100021,China;Ultrasonography Department,Beijing Chaoyang maternal and Child Health Hospital,Beijing 100021,China)
出处
《中国实验诊断学》
2021年第8期1153-1157,共5页
Chinese Journal of Laboratory Diagnosis
基金
2020年国家自然科学基金面上资助项目课题(81972424)。
关键词
适于胎龄儿
胎儿生长轨迹
胎盘功能不全
Appropriate-for-gestational-age
Fetal growth trajectory
placental insufficiency
