Danielian P J, Allman A C, Steer P J
Department of Obstetrics and Gynaecology, Charing Cross and Westminster Medical School, West London Hospital, UK.
Br J Obstet Gynaecol. 1992 Jun;99(6):452-4. doi: 10.1111/j.1471-0528.1992.tb13779.x.
To determine the perinatal outcome of fetuses who had birthweights less than that expected from early third trimester ultrasound scanning.
Retrospective estimation of centile fetal weight at early third trimester ultrasound scanning compared with actual centile birthweight corrected for gestational age, parity and sex.
Teaching Hospital Obstetric Unit, London.
197 unselected women with singleton cephalic pregnancies who were delivered at term in our unit between October 1989 and May 1990.
CTG abnormality, need for fetal blood sampling in labour, meconium-staining of the amniotic fluid, mode of delivery, Apgar scores at 1 and 5 min, need for transfer of baby to neonatal unit, and need for neonatal intubation of the neonate at delivery.
An actual birthweight greater than 5% less than the birthweight estimated from ultrasound scanning identified 44 babies (22%) with an increased risk of CTG abnormalities (chi 2 = 8.38, P less than 0.0025; Odds ratio (OR) = 2.54; 95% CI 1.36 to 4.78) and need for operative delivery (chi 2 = 5.81, P less than 0.0125; OR = 1.94; 95% CI 1.15 to 3.27), when compared with the remainder of the sample. Overall 14 (32%) of this group had birthweights above the 50th centile. A group of 44 babies selected as being the smallest for gestational age, without reference to growth pattern, had a similar excess morbidity. (All this group had birthweights below the 39th centile).
This study supports the hypothesis that in-utero fetal growth pattern is as important for perinatal outcome as being small for gestational age per se.
确定出生体重低于孕晚期超声扫描预期的胎儿的围产期结局。
回顾性评估孕晚期超声扫描时胎儿体重百分位数，并与根据孕周、产次和性别校正后的实际出生体重百分位数进行比较。
伦敦教学医院产科病房。
1989年10月至1990年5月在我院足月分娩的197例单胎头位妊娠未选择的妇女。
CTG异常、产时胎儿血样采集需求、羊水胎粪污染、分娩方式、1分钟和5分钟Apgar评分、婴儿转入新生儿病房的需求以及分娩时新生儿气管插管的需求。
实际出生体重比超声扫描估计的出生体重低5%以上，共识别出44例婴儿（22%），与样本其余部分相比，这些婴儿发生CTG异常的风险增加（χ² = 8.38，P < 0.0025；优势比（OR） = 2.54；95%可信区间1.36至4.78），且需要手术分娩（χ² = 5.81，P < 0.0125；OR = 1.94；95%可信区间1.15至3.27）。总体而言，该组中有14例（32%）出生体重高于第50百分位数。一组44例被选为孕周最小的婴儿，未考虑生长模式，其发病率也有类似增加。（该组所有婴儿出生体重均低于第39百分位数）。
本研究支持以下假设，即宫内胎儿生长模式对围产期结局的重要性与孕周小本身相当。
