Byun Young Ji, Kim Haeng-Soo, Yang Jeong In, Kim Joon Hyung, Kim Ho Yeon, Chang Suk Joon
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
Yonsei Med J. 2009 Feb 28;50(1):39-44. doi: 10.3349/ymj.2009.50.1.39. Epub 2009 Feb 24.
To evaluate the merit of umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age (SGA) infants.
A total of 218 patients at 27 - 36 weeks of gestational age (GA) who received antenatal umbilical artery Doppler velocimetry and delivered singleton infants with SGA. The ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery was measured in each patient. The patients were divided into 3 groups: the normal group with S/D ratios of less than 95th percentile (n = 134), elevated S/D ratio group of 95th or more percentile (n = 41), and those with absent/reversed end diastolic flow (n = 43). Maternal characteristics and neonatal outcomes of these groups were comparatively analyzed.
The gestational age (GA) at the time of diagnosis of SGA, the mean GA at delivery, and the mean birth weight showed statistically significant difference among three groups (p < 0.001). Also, poor perinatal outcome was significantly increased in infants with abnormal S/D ratio (13.4% vs. 31.7% vs. 67.4%, p < 0.001). Multivariate logistic regression analysis revealed umbilical artery Doppler study as a significant independent factor for prediction of poor perinatal outcome (odds ratio: 3.7, 95% confidence interval 1.4 - 9.5, p = 0.007).
Antenatal umbilical artery Doppler velocimetry is shown as a significantly efficient marker in predicting perinatal outcome in preterm SGA infants.
评估脐动脉多普勒研究作为预测早产小于胎龄（SGA）婴儿围产期结局指标的价值。
共有218例孕27 - 36周（GA）的患者接受了产前脐动脉多普勒测速，并分娩出单胎SGA婴儿。测量每位患者脐动脉收缩期峰值与舒张末期血流速度之比（S/D）。患者分为3组：S/D比值低于第95百分位数的正常组（n = 134）、S/D比值在第95百分位数及以上的升高组（n = 41）和舒张末期血流缺失/反向组（n = 43）。对这些组的母亲特征和新生儿结局进行了比较分析。
三组间SGA诊断时的孕周（GA）、分娩时的平均GA和平均出生体重差异有统计学意义（p < 0.001）。此外，S/D比值异常的婴儿围产期不良结局显著增加（13.4%对31.7%对67.4%，p < 0.001）。多因素逻辑回归分析显示脐动脉多普勒研究是预测围产期不良结局的重要独立因素（比值比：3.7，95%置信区间1.4 - 9.5，p = 0.007）。
产前脐动脉多普勒测速显示为预测早产SGA婴儿围产期结局的显著有效指标。
