Torrance Helen L, Mulder Eduard J H, Brouwers Hens A A, van Bel Frank, Visser Gerard H A
Perinatal Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
J Matern Fetal Neonatal Med. 2007 Aug;20(8):613-21. doi: 10.1080/14767050701463662.
To study respiratory outcome in preterm small for gestational age (SGA) fetuses with or without signs of intrauterine growth restriction due to placental insufficiency, and with or without maternal hypertension.
This was a retrospective study of 187 neonates with birth weight <10(th) percentile and gestational age <34 weeks. Results from umbilical artery Doppler velocimetry were used to identify the abnormal Doppler subgroup.
No significant difference in respiratory outcome between SGA fetuses with normal (SGA-N) or abnormal (SGA-A) umbilical artery Doppler examination was found. Within the SGA-A group, the respiratory distress syndrome (RDS) incidence (OR 5.6, 95% CI 1.7-18.3), RDS grade (OR 6.7, 95% CI 1.2-38.5), and need for surfactant (OR 5.3, 95% CI 1.1-24.4) were higher in infants of women with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome as compared to those of normotensive mothers.
Lung maturation is not accelerated with placental insufficiency. SGA-A fetuses of mothers with HELLP syndrome have a significantly poorer respiratory outcome than those with healthy mothers. Possibly, fetuses of mothers with HELLP syndrome are subjected to 'oxidative stress' causing lung damage rather than lung maturation.
研究胎龄小于孕周的早产小于胎龄儿（SGA），无论有无因胎盘功能不全导致的宫内生长受限迹象，以及有无母亲高血压时的呼吸结局。
这是一项对187例出生体重<第10百分位数且胎龄<34周的新生儿进行的回顾性研究。脐动脉多普勒测速结果用于识别异常多普勒亚组。
脐动脉多普勒检查正常（SGA-N）或异常（SGA-A）的SGA胎儿在呼吸结局方面未发现显著差异。在SGA-A组中，与血压正常母亲的婴儿相比，患有溶血、肝酶升高、血小板减少（HELLP）综合征的母亲所生婴儿的呼吸窘迫综合征（RDS）发生率（比值比5.6，95%可信区间1.7-18.3）、RDS分级（比值比6.7，95%可信区间1.2-38.5）及表面活性剂需求（比值比5.3，95%可信区间1.1-24.4）更高。
胎盘功能不全不会加速肺成熟。患有HELLP综合征母亲的SGA-A胎儿的呼吸结局明显比健康母亲的胎儿差。可能患有HELLP综合征母亲的胎儿受到“氧化应激”，导致肺损伤而非肺成熟。
