在极度早产的生长受限胎儿中,死亡率和严重的神经疾病率
E Mazarico1,2,3, E Meler4, M Mendoza5
1Hospital Sant Joan de Déu, BCNatal, Barcelona, Spain.
概括
预测28周前分娩的生长受限胎儿的不良结果是可能的. 将估计的胎儿体重,性别和多普勒阶段与妊娠年龄相结合,可以提高对死亡率或神经问题的预测准确度.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿科学 新生儿科学
- 围产期流行病学 围产期流行病学
背景情况:
- 胎儿生长限制 (FGR) 存在重大风险,特别是在28周前的早产.
- 准确预测周产期不良结果对于个性化咨询和管理至关重要.
研究的目的:
- 开发和验证预测模型,用于怀孕28周前需要分娩的怀疑FGR的胎儿的不良周产后结果.
- 增强个性化的患者咨询和决策.
主要方法:
- 追溯多中心队列研究单子怀孕的FGR需要在28周前分娩.
- 使用产前变量开发了后勤回归模型,以预测死亡率和复合不良结果 (死亡率或严重神经疾病).
- 模型通过外部验证,使用接收器运行特征 (ROC) 曲线分析.
主要成果:
- 新生儿死亡率为37.3%;在幸存者中,严重的神经疾病率为21.7%.
- 死亡率的预测模型包括:硫酸神经保护,妊娠年龄,预计胎儿体重,男性性别和多普勒阶段 (AUC=0.810).
- 综合不良结果的预测模型包括:妊娠年龄,男性性别和多普勒阶段 (AUC=0.810).
- 外部验证证实了两种模型的类似预测性能.
结论:
- 估计的胎儿体重,胎儿性别和多普勒阶段,加上妊娠年龄,显著改善了预测早产FGR胎儿的不良结果.
- 这些模型为父母咨询和高风险怀孕中的临床决策提供了宝贵的工具.
- 这些发现支持使用多模式评估来改善围产期结果预测.
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