使用不同的图表和对胎儿生长限制的定义来预测不良结果的产前预测
M Mascherpa1,2, C Pegoire1, A Meroni1,3
1Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.
概括
不同的胎儿生长限制 (FGR) 定义和图表影响患病率,但识别不良结果的敏感性仍然很低. 估计的胎儿体重和子宫动脉脉动指数是关键预测指标.
科学领域:
- 产科和妇科 产科和妇科
- 胎儿医学 胎儿医学
- 围产期健康 围产期健康
背景情况:
- 产前超声波评估胎儿的生长,以确定有不良周围生育结果风险的胎儿.
- 胎儿生长限制 (FGR) 的定义和参考图表各不相同,可能会影响风险评估.
研究的目的:
- 评估不同的FGR定义和体重图表如何影响胎儿不理想生长和不良周产期结果之间的关联.
- 为了比较各种FGR定义和参考标准的测试特征.
主要方法:
- 对17,261个单独怀孕的回顾性队列研究.
- 使用INTERGROWTH-21st,Hadlock,FMF和瑞典图表来估计胎儿体重 (EFW) 和多普勒指数.
- 使用共识,SMFM和瑞典标准评估FGR;不良结果包括围产死亡,新生儿重症监护室入院,低Apgar分数和治疗冷却.
主要成果:
- 根据使用的定义和图表,FGR的患病率有很大差异 (例如,1.5%至10.6%).
- 对不良结果的敏感性在4.4%至13.2%之间,而特异性在89.4%至98.6%之间.
- 子宫动脉脉动指数 (UtA-PI) >95百分点和EFW<5百分点始终与不良结果相关.
结论:
- 对不良结果的FGR流行率和检测率在很大程度上取决于所选择的定义和参考标准.
- 虽然EFW和UtA-PI是重要的预测指标,但它们的相关性需要预测算法来提高准确性.
- 目前的方法在识别高风险的胎儿的敏感性上存在局限性.
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