影响动脉的因素 在第二和第三季度的多普勒基准值
Sophia Rahimi1,2, John C Kingdom1,3, Arietta Vayenas2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
概括
方法因素,特别是估计胎儿体重 (EFW) 百分点切线,显著影响动脉脉动指数 (UA-PI) 参考图表,导致临床解释中观察到的异质性.
科学领域:
- 围产儿医学 围产儿医学
- 胎儿生理学 胎儿生理学
- 医学统计 医学统计
背景情况:
- 动脉脉动指数 (UA-PI) 是胎儿健康的一个关键指标.
- 已发表的UA-PI参考图表表现出相当多的异质性,使准确的临床解释变得复杂.
- 在图表构建中的方法变化被怀疑是这种异质性的贡献者.
研究的目的:
- 调查特定的方法因素对已公布的UA-PI参考图表的可变性的影响.
- 确定哪些因素,如队列特征和统计建模,对图表异质性贡献最大.
主要方法:
- 分析了一大批数据集 (来自12,394个怀孕的25069个UA-PI测量) 来自不复杂的单独怀孕.
- 探讨队列特征的影响:平价和估计胎儿体重 (EFW) 百分点截止值.
- 评估不同的统计建模方法对构建UA-PI百分点参考图表的影响.
主要成果:
- 包含EFW百分位数的切断值显著影响了UA-PI百分位数值;较高的切断值导致UA-PI升高的检测增加.
- 使用EFW>25或50个百分点的图表与使用EFW>10个百分点的图表相比,发现了更多的怀孕年龄较小的胎儿,UA-PI>95个百分点.
- 平价和统计建模方法对得到的UA-PI参考图表的影响最小.
结论:
- 用于创建UA-PI参考图表的EFW百分点在人口中的分布是异质性的主要驱动因素.
- 对UA-PI的临床解释可能会因参考图的构建方法,特别是其EFW包含标准而有很大差异.
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