Secher N J, Lundbye-Christensen S, Qvist I, Bagger P
Department of Obstetrics and Gynecology, Arhus Kommunehospital, Denmark.
Eur J Obstet Gynecol Reprod Biol. 1991 Jan 30;38(2):91-6. doi: 10.1016/0028-2243(91)90183-l.
In 58 small for gestational age (SGA) infants and 141 non-SGA infants, the measuring of symphysis fundal distance (SF) was compared with clinical estimation of fetal weight in order to evaluate the efficacy of the two methods of predicting SGA. By regression analyses, the SF curve deviation explains 22% of the variation of birthweight. The estimated fetal weight (EFW) curve deviation explains 40%. By combining the two values, 42% of the variation in birthweight is explained. When receiver operating characteristic (ROC) curve analyses, Kappa index and relative risk were applied the clinical estimation of fetal weight by abdominal palpation was found to be as reliable a predictor of SGA at birth as the measurement of the SF distance. Statistical analyses of the SF curve and EFW curve do not improve the results compared with the last measurement of SF distance and EFW. Combination of the EFW and SF measurements results in a higher sensitivity (one test positive) or a higher predictive value (both tests positive). Only marginal additional diagnostic information was achieved, however, as the ROC curves, Kappa index and Relative risk were nearly unchanged, regardless of combination of EFW and SF measurements.
在58例小于胎龄儿（SGA）和141例非SGA婴儿中，对比了测量宫底高度（SF）与临床估计胎儿体重，以评估这两种预测SGA方法的有效性。通过回归分析，SF曲线偏差解释了出生体重变化的22%。估计胎儿体重（EFW）曲线偏差解释了40%。将这两个值结合起来，可解释出生体重变化的42%。当应用受试者工作特征（ROC）曲线分析、kappa指数和相对风险时，发现通过腹部触诊临床估计胎儿体重与测量SF距离一样，是出生时SGA的可靠预测指标。与最后一次测量的SF距离和EFW相比，SF曲线和EFW曲线的统计分析并未改善结果。EFW和SF测量结果相结合可产生更高的敏感性（一项检测呈阳性）或更高的预测值（两项检测均呈阳性）。然而，仅获得了少量额外的诊断信息，因为无论EFW和SF测量如何组合，ROC曲线、kappa指数和相对风险几乎没有变化。
