Ben-Haroush Avi, Melamed Nir, Mashiach Reuven, Meizner Israel, Yogev Yariv
Department of Obstetrics and Gynecology, Helen Schneider's Hospital for Women, Rabin Medical Center, 49100 Petach Tikva, Israel.
J Ultrasound Med. 2008 Jul;27(7):1029-32. doi: 10.7863/jum.2008.27.7.1029.
The purpose of this study was to assess the value of combining the sonographically estimated fetal weight (EFW) and amniotic fluid index (AFI) measured within 10 days of term delivery for prediction of macrosomia at birth.
Prospective sonographic fetal biometric measurements and delivery ward data of a single center, uploaded separately over a 4-year period, were retrospectively linked to yield an unselected sample of nondiabetic pregnancies with live-born term neonates.
Of the 1925 pregnancies evaluated, 140 (7.2%) were macrosomic (birth weight > or =4000 g). The AFI was significantly higher in the macrosomic group (P < .001). On receiver operating characteristic curve analysis, the area under the curve was larger for predictions based on the EFW alone than on the AFI. An EFW of 4000 g or higher had a positive predictive value of 46.6% for macrosomia at birth. Use of the previously suggested combined EFW and AFI cutoffs of 3689 g and 119 mm, respectively, yielded a positive predictive value of 30.3%.
Combined use of the EFW and AFI rather than the EFW alone does not improve prediction of macrosomia at birth.
本研究旨在评估在足月分娩前10天内测量的超声估计胎儿体重（EFW）和羊水指数（AFI）相结合对预测出生时巨大儿的价值。
回顾性地将一个单一中心在4年期间分别上传的前瞻性超声胎儿生物测量数据和产房数据进行关联，以获得一个未选择的非糖尿病活产足月新生儿妊娠样本。
在评估的1925例妊娠中，140例（7.2%）为巨大儿（出生体重≥4000g）。巨大儿组的AFI显著更高（P<.001）。在受试者工作特征曲线分析中，仅基于EFW的预测曲线下面积大于基于AFI的预测。出生体重4000g或更高时，对出生时巨大儿的阳性预测值为46.6%。分别使用先前建议的EFW和AFI联合临界值3689g和119mm时，阳性预测值为30.3%。
联合使用EFW和AFI而非仅使用EFW并不能改善对出生时巨大儿的预测。
