Zhang Xun, Cnattingius Sven, Platt Robert W, Joseph K S, Kramer Michael S
Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
J Pediatr. 2007 Jun;150(6):603-7, 607.e1-3. doi: 10.1016/j.jpeds.2007.01.048.
To examine whether the smaller size of infants born to primiparous, short, or thin mothers is associated with increased risks of perinatal mortality.
We compared gestational age-specific patterns of "revealed" small-for-gestational-age (SGA) birth (number of SGA births expressed as a proportion of fetuses remaining in utero at each gestational age) with the patterns for perinatal mortality among singleton late fetal deaths and live births (n = 791,523) to Swedish mothers in 1992 to 2001.
Based on a single standard for SGA, primiparae were at substantially higher risk of revealed SGA throughout gestation, paralleling the pattern for perinatal mortality. However, for short and thin women, risks of revealed SGA were much more consistent with those for perinatal mortality when SGA was based on height-specific or body mass index-specific standards, respectively, rather than on the single standard. Overweight and obese mothers had lower revealed SGA rates based on either standard but higher perinatal mortality rates.
Slower fetal growth due to maternal short stature or low prepregnancy body mass index appears to be physiologic, whereas the slower growth of fetuses born to primiparous women is associated with higher risks of perinatal death.
探讨初产妇、身材矮小或体型消瘦的母亲所生婴儿体型较小是否与围产期死亡风险增加相关。
我们比较了1992年至2001年瑞典母亲单胎晚期胎儿死亡和活产（n = 791,523）中“暴露的”小于胎龄儿（SGA）出生的孕周特异性模式（SGA出生数表示为每个孕周留在子宫内胎儿的比例）与围产期死亡率模式。
基于单一的SGA标准，初产妇在整个孕期发生暴露性SGA的风险显著更高，这与围产期死亡率模式相似。然而，对于身材矮小和体型消瘦的女性，当SGA分别基于身高特异性或体重指数特异性标准而非单一标准时，暴露性SGA的风险与围产期死亡率的风险更为一致。超重和肥胖母亲基于任何一种标准的暴露性SGA发生率较低，但围产期死亡率较高。
由于母亲身材矮小或孕前体重指数低导致的胎儿生长缓慢似乎是生理性的，而初产妇所生胎儿生长缓慢与围产期死亡风险较高相关。
