Haddad Bassam, Kayem Gilles, Deis Stephanie, Sibai Baha M
Department of Obstetrics and Gynecology, University of Paris XII, Créteil, Paris, France.
Am J Obstet Gynecol. 2007 Mar;196(3):237.e1-5. doi: 10.1016/j.ajog.2006.10.905.
The purpose of this study was to compare perinatal and maternal outcomes in women with singleton pregnancies and severe preeclampsia (SPE) expectantly managed at 24-33 weeks' gestation (wk) that resulted at birth in severe intrauterine growth restriction (SIUGR, < 5th percentile) to those without SIUGR.
Two hundred thirty-nine women undelivered after antenatal steroids were expectantly managed. Perinatal and maternal outcomes were analyzed according to fetal growth status. Students t-test, chi-square test, logistic regression analysis, and odds ratio were calculated.
Fifty-eight pregnancies resulted in an SIUGR neonate. Median latency periods (5 vs 5 d) and delivery gestational ages (30.6 vs 30.3 wk) were similar in the 2 groups. Controlling for gestational age at delivery, only fetal death remained associated with SIUGR (OR: 6.4; 95% CI 1.05-39.35, P = .04). Maternal outcomes were similar in the 2 groups.
In severe preeclamptic women at 24-33 weeks, SIUGR is associated with increased risk of fetal death but does not affect maternal complications.
本研究旨在比较孕周为24 - 33周时期待治疗的单胎妊娠重度子痫前期(SPE)患者中,出生时发生严重宫内生长受限(SIUGR,低于第5百分位数)与未发生SIUGR患者的围产期及母体结局。
对239例接受产前类固醇治疗后未分娩的患者进行期待治疗。根据胎儿生长状况分析围产期及母体结局。计算学生t检验、卡方检验、逻辑回归分析和比值比。
58例妊娠分娩出SIUGR新生儿。两组的中位潜伏期(5天对5天)和分娩孕周(30.6周对30.3周)相似。在控制分娩孕周后,仅胎儿死亡与SIUGR相关(比值比:6.4;95%可信区间1.05 - 39.35,P = 0.04)。两组的母体结局相似。
在孕周为24 - 33周的重度子痫前期女性中,SIUGR与胎儿死亡风险增加相关,但不影响母体并发症。