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通过体积描记法测量的新生儿肥胖不能由妊娠晚期胎儿生长的二维超声测量来预测。

Newborn adiposity measured by plethysmography is not predicted by late gestation two-dimensional ultrasound measures of fetal growth.

作者信息

Moyer-Mileur Laurie J, Slater Hillarie, Thomson J Anne, Mihalopoulos Nicole, Byrne Jan, Varner Michael W

机构信息

Center for Pediatric Nutrition Research, University of Utah, Salt Lake City, UT 84158, USA.

出版信息

J Nutr. 2009 Sep;139(9):1772-8. doi: 10.3945/jn.109.109058. Epub 2009 Jul 29.

Abstract

Noninvasive measures of fetal and neonatal body composition may provide early identification of children at risk for obesity. Air displacement plethysmography provides a safe, precise measure of adiposity and has recently been validated in infants. Therefore, we explored relationships between term newborn percent body fat (%BF) measured by air displacement plethysmography to 2-dimensional ultrasound (2-D US) biometric measures of fetal growth and maternal and umbilical cord endocrine activity. A total of 47 mother/infant pairs were studied. Fetal biometrics by 2-D US and maternal blood samples were collected during late gestation (35 wk postmenstrual age); infants were measured within 72 h of birth. Fetal biometrics included biparietal diameter, femur length, head circumference, abdominal circumference (AC), and estimated fetal weight (EFW). Serum insulin, insulin-like growth factor (IGF) 1, IGF binding protein-3, and leptin concentrations were measured in umbilical cord and maternal serum. The mean %BF determined by plethysmography was 10.9 +/- 4.8%. EFW and fetal AC had the largest correlations with newborn %BF (R(2) = 0.14 and 0.10, respectively; P < 0.05); however, stepwise linear regression modeling did not identify any fetal biometric parameters as a significant predictor of newborn %BF. Newborn mid-thigh circumference (MTC; cm) and ponderal index (PI; weight, kg/length, cm(3)) explained 21.8 and 14.4% of the variability in %BF, respectively, and gave the best stepwise linear regression model (%BF = 0.446 MTC + 0.347 PI -29.692; P < 0.001). We conclude that fetal growth biometrics determined by 2-D US do not provide a reliable assessment of %BF in term infants.

摘要

胎儿和新生儿身体成分的非侵入性测量方法可能有助于早期识别有肥胖风险的儿童。空气置换体积描记法可安全、精确地测量肥胖程度,最近已在婴儿中得到验证。因此,我们探讨了通过空气置换体积描记法测量的足月儿体脂百分比(%BF)与二维超声(2-D US)测量的胎儿生长以及母体和脐带内分泌活动之间的关系。共研究了47对母婴。在妊娠晚期(月经龄35周)通过二维超声测量胎儿生物指标并采集母体血样;婴儿在出生后72小时内进行测量。胎儿生物指标包括双顶径、股骨长度、头围、腹围(AC)和估计胎儿体重(EFW)。测量脐带血和母血中血清胰岛素、胰岛素样生长因子(IGF)1、IGF结合蛋白-3和瘦素浓度。通过体积描记法测定的平均%BF为10.9±4.8%。EFW和胎儿AC与新生儿%BF的相关性最大(R²分别为0.14和0.10;P<0.05);然而,逐步线性回归模型未将任何胎儿生物指标参数确定为新生儿%BF的显著预测指标。新生儿大腿中部周长(MTC;cm)和 ponderal指数(PI;体重,kg/身长,cm³)分别解释了%BF变异性的21.8%和14.4%,并给出了最佳逐步线性回归模型(%BF = 0.446 MTC + 0.347 PI -29.692;P<0.001)。我们得出结论,二维超声测定的胎儿生长生物指标不能可靠地评估足月儿的%BF。

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