Hata T, Kuno A, Akiyama M, Yanagihara T, Manabe A, Miyazaki K
Department of Perinatology, Kagawa Medical University, Kagawa, Japan.
Gynecol Obstet Invest. 1999;47(3):162-5. doi: 10.1159/000010085.
Our objective was to evaluate individualized growth assessment using the Rossavik growth model for detection of small-for-gestational-age (SGA) infants with a poor perinatal outcome.
Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 47 singleton SGA infants. Individual fetal growth curve standards for head and abdominal circumference, and weight were determined from the data of two scans obtained before 25 weeks' menstrual age and separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index (GPRI) and Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes [mechanical delivery, low Apgar score, abnormal fetal heart rate (FHR) patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit (NICU) admission and maternal complications] were compared between SGA infants with normal NGAS and those with abnormal NGAS.
Of the 47 fetuses studied, 27 had normal growth outcomes at birth and 20 showed evidence of intrauterine growth restriction, based on NGAS. There were significant increases in mechanical deliveries, abnormal FHR patterns and meconium staining of amniotic fluid in cases of growth-restricted neonates, determined using the NGAS classification, when compared with events related to normally grown infants. However, there were no significant differences in low Apgar score, neonatal acidosis, NICU admission and maternal complications between the 2 groups.
Individualized growth assessment should be useful for detection of SGA infants with poor perinatal outcomes.
我们的目的是评估使用罗萨维克生长模型进行个体化生长评估，以检测围产期结局不良的小于胎龄（SGA）婴儿。
利用孕中期超声测量得出的罗萨维克生长模型来预测47名单胎SGA婴儿的出生特征。根据在月经龄25周之前获得的两次扫描数据（间隔至少5周）确定头围、腹围和体重的个体胎儿生长曲线标准。实际出生特征与预测出生特征之间的比较通过生长潜力实现指数（GPRI）和新生儿生长评估评分（NGAS）来表示。比较NGAS正常的SGA婴儿和NGAS异常的SGA婴儿围产期结局[机械分娩、低Apgar评分、异常胎儿心率（FHR）模式、新生儿酸中毒、羊水胎粪污染、新生儿重症监护病房（NICU）入院和母亲并发症]的比例。
在所研究的47例胎儿中，根据NGAS，27例出生时生长结局正常，20例有宫内生长受限的证据。与正常生长婴儿相关的事件相比，使用NGAS分类法确定的生长受限新生儿的机械分娩、异常FHR模式和羊水胎粪污染显著增加。然而，两组之间在低Apgar评分、新生儿酸中毒、NICU入院和母亲并发症方面没有显著差异。
个体化生长评估对于检测围产期结局不良的SGA婴儿应该是有用的。
