胎儿生长图的预测能力在识别幼儿园年龄发展挑战:一个队列研究
Ariadna Fernandez1, Jessica Liauw2, Chantal Mayer2
1Faculty of Medicine, Department of Obstetrics and Gynaecology, University of British Columbia, BC Women's Hospital + Health Centre, Vancouver, Canada (Ms Fernandez).
American journal of obstetrics & gynecology MFM
|November 9, 2023
概括
低估计的胎儿体重百分位与儿童的发育风险相关. 然而,目前的胎儿生长图表并不准确地预测幼儿时期的个体发展挑战.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 儿科发展 儿科发展
- 生物统计学 生物统计学
背景情况:
- 胎儿生长限制 (FGR) 定义为估计的胎儿体重 (EFW) 或腹周 < 10 个百分点.
- 对于EFW存在多个基于人口的参考资料,需要评估它们对婴儿结果的预测准确性.
- FGR与短期并发症之外的长期儿童发展问题有关.
研究的目的:
- 通过INTERGROWTH-21st和世卫组织图表,评估EFW百分位数与幼儿园儿童发育之间的关联.
- 确定这些图表在预测幼儿园年龄的发展挑战时的歧视能力.
主要方法:
- 追溯队列研究将产科超声波数据与幼儿园测试结果联系起来.
- 使用INTERGROWTH-21st和WHO图表对单个,非异常胎儿 (妊娠28周以上) 的EFW百分位进行分类.
- 通用增材建模和ROC曲线分析评估了EFW百分位数与早期发展仪器 (EDI) 成绩的相关性.
主要成果:
- 较低的EFW百分位与较低的EDI分数和在人口层面上增加的发育脆弱性有关.
- 这种关联的大小很小 (例如,在INTERGROWTH-21st图表上,第3至第9个百分点的EDI总得分为-2.8分).
- 所有评估的图表显示,对儿童不良发育的预测能力有限 (曲线下的面积<0.53).
结论:
- 在INTERGROWTH-21st和世卫组织图表中,EFW百分位数较低表明,儿童发育不良的风险在人口水平上增加.
- 这些图表不足以准确地预测个体不良儿童发育结果.
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