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胎儿生长调节与宫内生长迟缓

Fetal growth regulation and intrauterine growth retardation.

作者信息

Carrascosa Antonio, Yeste Diego, Copil Alejandra, Audí Laura, Gusinyé Miquel, Vicens-Calvet Enric, Clemente María

机构信息

Children 's Hospital Vall d'Hebron, Autonomous University of Barcelona, Spain.

出版信息

J Pediatr Endocrinol Metab. 2004 Mar;17 Suppl 3:435-43.

Abstract

Gestational age and neonatal anthropometric parameters are currently used to evaluate fetal growth and are predictive factors of perinatal and postnatal morbidity and mortality. We performed a retrospective analysis of neonatal anthropometric parameters (weight, vertex-heel length and head circumference) in 1,470 live preterm neonates born between 1997 and 2002 and a prospective analysis of the same parameters in 1,786 live newborns of both sexes born in 2001 and 2002, products of single 37-42 week uncomplicated pregnancies in healthy Spanish Caucasian mothers. A progressive increase in these parameters with gestational age and sexual dimorphism were observed from the 30th week of gestational age onwards, with statistically-significant differences (p<0.05) at 38-42 weeks of gestational age. An increase in weight and length values in relation to previous Spanish studies was also documented in preterm newborns. It is estimated that 10-15% of children born small for gestational age (SGA) do not experience catch-up growth by the age of 3 years and may have short stature in adulthood. Preliminary data of a cross-sectional study on spontaneous growth in boys and girls born SGA without postnatal catch-up growth show that their +2 SD values of height are similar to -2 SD values of our normal control population of children born with adequate weight and length for gestational age (AGE). However, weight +2 SD values are similar to mean values of control children born AGE. In summary, our data show sexual dimorphism in neonatal anthropometric growth parameters and that these parameters change with time and may be updated. In addition children born SGA without postnatal catch-up are shorter and have higher weight than age-, height- and sex-matched controls born AGE.

摘要

目前,胎龄和新生儿人体测量参数用于评估胎儿生长情况,并且是围产期及产后发病率和死亡率的预测因素。我们对1997年至2002年间出生的1470例存活早产新生儿的新生儿人体测量参数(体重、顶跟长度和头围)进行了回顾性分析,并对2001年和2002年出生的1786例男女存活新生儿的相同参数进行了前瞻性分析,这些新生儿均为健康的西班牙白种母亲单胎37 - 42周无并发症妊娠的产物。从孕30周起,观察到这些参数随胎龄增加而逐渐上升且存在性别差异,在孕38 - 42周时具有统计学显著差异(p<0.05)。与西班牙以往的研究相比,早产新生儿的体重和长度值也有所增加。据估计,10% - 15%的小于胎龄儿(SGA)在3岁时未实现追赶生长,成年后可能身材矮小。一项关于未经历产后追赶生长的SGA出生男孩和女孩自然生长的横断面研究的初步数据显示,他们身高的 +2 SD值与我们正常对照组中出生时体重和长度符合胎龄(AGE)的儿童的 -2 SD值相似。然而,体重的 +2 SD值与出生时符合AGE的对照儿童的平均值相似。总之,我们的数据显示新生儿人体测量生长参数存在性别差异,并且这些参数随时间变化,可能需要更新。此外,未经历产后追赶生长的SGA出生儿童比出生时符合AGE、身高和性别的对照儿童更矮但体重更高。

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