单纯性过期妊娠中的有核红细胞。

Nucleated red blood cells in uncomplicated prolonged pregnancy.

作者信息

Perri Tamar, Ferber Asaf, Digli Ayala, Rabizadeh Esther, Weissmann-Brenner Alina, Divon Michael Y

机构信息

Department of Obstetrics and Gynecology, Rabin Medical Center, Petah-Tikva, Israel.

出版信息

Obstet Gynecol. 2004 Aug;104(2):372-6. doi: 10.1097/01.AOG.0000133483.94020.04.

DOI:10.1097/01.AOG.0000133483.94020.04

PMID:15292014

Abstract

OBJECTIVE

Elevated counts of nucleated red blood cells (NRBCs), as well as prolongation of pregnancy, have been suggested as predictors of adverse perinatal outcome. However, the association between these 2 variables has received only minimal attention. We sought to evaluate fetal NRBCs in prolonged pregnancies.

METHODS

Umbilical cord blood was prospectively collected at delivery from 75 prolonged (at or beyond 287 days) pregnancies. One hundred and fifty term deliveries (260-286 days) served as controls. All pregnancies were accurately dated with the use of first-trimester sonography. Fetal biophysical profile testing was initiated at 40 weeks of gestation. Patients were delivered if they were in spontaneous labor or the biophysical profile was nonreassuring or by 42 weeks of gestation. Nucleated red blood cell counts were expressed per 100 white blood cells (WBC). Umbilical artery pH studies, as well as other demographic and clinical variables, were obtained.

RESULTS

Prolonged pregnancy was associated with a significantly increased incidence of induction of labor and a greater birth weight. There were no other differences between the study group and controls. The median NRBCs per 100 WBCs in prolonged pregnancy was not significantly elevated over the term values (median 3, range 0-35 versus median 3, range 0-34, respectively; P =.25). Neonatal outcome was also comparable between groups. The univariate regression analysis demonstrated a significant association between elevated NRBC counts and low arterial cord blood pH (P <.008, R = 0.175), elevated base excess (P =.02, R = 0.149), low platelet counts (P =.046, R = 0.134), and male gender (P =.028). Stepwise regression analysis revealed that low arterial cord blood pH and male gender were the only independent variables predicting elevated NRBC counts at birth.

CONCLUSION

The findings of this study suggest that elevated NRBC counts are associated with specific pregnancy complications rather than uncomplicated prolonged pregnancies in general.

摘要

目的

有核红细胞（NRBC）计数升高以及孕期延长被认为是围产期不良结局的预测指标。然而，这两个变量之间的关联仅受到极少关注。我们试图评估过期妊娠中的胎儿NRBC。

方法

前瞻性收集了75例过期妊娠（287天及以上）分娩时的脐带血。150例足月分娩（260 - 286天）作为对照。所有妊娠均通过孕早期超声准确确定孕周。妊娠40周开始进行胎儿生物物理评分检查。如果患者自然临产、生物物理评分不令人满意或妊娠42周，则进行分娩。有核红细胞计数以每100个白细胞（WBC）表示。获取脐动脉pH研究以及其他人口统计学和临床变量。

结果

过期妊娠与引产发生率显著增加和出生体重增加有关。研究组与对照组之间无其他差异。过期妊娠中每100个WBC的NRBC中位数与足月时的值相比无显著升高（中位数分别为3，范围0 - 35和中位数3，范围0 - 34；P = 0.25）。两组间新生儿结局也具有可比性。单因素回归分析显示，NRBC计数升高与脐动脉血低pH（P < 0.008，R = 0.175）、碱剩余升高（P = 0.02，R = 0.149）、血小板计数低（P = 0.046，R = 0.134）和男性性别（P = 0.028）之间存在显著关联。逐步回归分析显示，脐动脉血低pH和男性性别是预测出生时NRBC计数升高的唯一独立变量。