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Updated: Jan 30, 2026

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通过选择胎儿生长参考来预测期满妊娠中不良周产期结果的差异:一个验证研究
Linda Lindström1, Fredrik Ahlsson1, Ove Axelsson1,2
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Acta obstetricia et gynecologica Scandinavica
|January 29, 2026
概括
不同的胎儿生长参考以不同的准确度识别出小于妊娠年龄 (SGA) 的婴儿. 林德斯特罗姆参考标准最大限度地检测有风险的胎儿,而世卫组织参考标准则提供了对周产期不良结果的敏感性和错误阳性率之间的平衡.
科学领域:
- 围产儿医学 围产儿医学
- 新生儿科学 新生儿科学
- 产科 产科 产科 产科 产科
背景情况:
- 胎儿生长参考对于识别妊娠年龄 (SGA) 小的婴儿至关重要.
- 评估不同的参考资料对于准确评估周产期不良结果的风险至关重要.
- 四个参考资料进行了比较:Lindström等人,Maršál等人,世卫组织和INTERGROWTH-21st (IG21st).
研究的目的:
- 评估胎儿生长异常与终期怀孕中不良周产期结果之间的关联.
- 为了比较四个不同的胎儿生长参考标准在识别高风险SGA婴儿时的表现.
- 确定临床实践中关于产周风险分层的最佳参考.
主要方法:
- 这是一项基于人口的队列研究,对瑞典1,126,059个单期分娩 (2010-2020年) 进行了研究.
- 使用四个不同的胎儿生长参考值计算出出生体重百分比.
- 分析了围产期不良结果,逻辑回归模型评估了SGA值的预测性表现,灵敏度和假阳性率 (FPR).
主要成果:
- 在参考数据中观察到出生体重百分点分布的显著变化.
- 林德斯特罗姆参考确定了SGA婴儿的比例最高,产生了最高的灵敏度,但也是最高的FPR.
- 第21次IG参考确定了SGA婴儿比例最低的婴儿,灵敏度最低的婴儿和FPR.
- 所有的参考资料显示了类似的整体预测性能 (C指数≈0.67),但在区分能力上有所不同.
结论:
- 胎儿生长参考表现出可比的整体预测能力,但在敏感性和FPR对周围生育不良结果的显著差异.
- 当最大限度地识别有风险的胎儿是优先事项时,建议使用Lindström参考.
- 建议在临床实践中使用世卫组织的参考标准,当预产期婴儿需要敏感性和FPR之间的平衡时.
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