在1型和2型糖尿病中使用胎儿生物识别来预测出生时的妊娠年龄大:一项回顾性队列研究
Sidsel L Rathcke1,2,3, Marianne M Sinding1,3, Trine T Christensen2,4
1Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark.
概括
在1型和2型糖尿病的怀孕中,腹周和胎儿估计体重比头周和腹周的比率更好地预测孕期新生儿的大小. 母亲因素改善了2型糖尿病的预测.
科学领域:
- 孕产妇和胎儿的医学
- 糖尿病学 糖尿病学
- 医学成像医学成像
背景情况:
- 妊娠糖尿病和先前存在的糖尿病 (1型和2型) 与妊娠年龄大 (LGA) 新生儿的风险增加有关.
- 准确预测LGA对于适当管理和预防不良围产期结果至关重要.
研究的目的:
- 为了比较胎儿头周长 (HC),腹周长 (AC),HC/AC比率和估计胎儿体重 (EFW) 的预测性表现,用于LGA在1型糖尿病 (T1DM) 和2型糖尿病 (T2DM) 复杂的怀孕中.
主要方法:
- 在2010-2019年间对单子婴儿的回顾性队列研究.
- 超声波测量 (HC,AC,EFW) 在怀孕16周,20周,28周和34周进行评估.
- 逻辑回归和接收器运行特征曲线 (AUC) 下的区域用于评估LGA (≥第90个百分点) 的预测.
主要成果:
- 在T1DM怀孕中,AC和EFW的AUC比HC/AC比率 (0.67) 高 (28周时为0.85和0.86). 多变量分析没有改善预测.
- 在T2DM怀孕中,AC和EFW也表现出强大的预测性能 (AUC为0.83和0.87在28周).
- 在T2DM中,包括母性特征和HbA1c在内的多变量分析显著改善了从怀孕20周开始的LGA预测.
结论:
- 胎儿过度生长,影响AC和HC,在T1DM和T2DM怀孕中具有LGA的特征.
- 在这些人群中,AC和EFW在预测LGA方面优于HC/AC比率.
- 母亲因素和HbA1c在T2DM中增强LGA预测,但不是T1DM.
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