前置胎盘对胎儿生长的影响。
Effect of placenta previa on fetal growth.
机构信息
Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
出版信息
Am J Obstet Gynecol. 2010 Oct;203(4):330.e1-5. doi: 10.1016/j.ajog.2010.05.014.
OBJECTIVE
To estimate the association between placenta previa and abnormal fetal growth.
STUDY DESIGN
Retrospective cohort study of consecutive women undergoing ultrasound between 15 and 22 weeks. Groups were defined by the presence or absence of complete or partial placenta previa. The primary outcome was intrauterine growth restriction (IUGR), defined as a birthweight <10th percentile by the Alexander growth standard. Univariable, stratified, and multivariable analyses were used to estimate the effect of placenta previa on fetal growth restriction.
RESULTS
Of 59,149 women, 724 (1.2%) were diagnosed with a complete or partial previa. After adjusting for significant confounding factors (black race, gestational diabetes, preeclampsia, and single umbilical artery), the risk of intrauterine growth restriction remained similar (adjusted odds ratio, 1.1; 95% confidence interval, 0.9-1.5). The presence of bleeding did not impact the risk of growth restriction.
CONCLUSION
Placenta previa is not associated with fetal growth restriction. Serial growth ultrasounds are not indicated in patients with placenta previa.
目的
评估前置胎盘与胎儿生长异常之间的关系。
研究设计
这是一项连续接受 15 至 22 周超声检查的女性的回顾性队列研究。通过是否存在完全性或部分性前置胎盘来定义组别。主要结局是宫内生长受限（IUGR），定义为亚历山大生长标准中出生体重低于第 10 百分位数。采用单变量、分层和多变量分析来估计前置胎盘对胎儿生长受限的影响。
结果
在 59149 名女性中，724 名（1.2%）被诊断为完全性或部分性前置胎盘。在调整了显著混杂因素（黑种人、妊娠期糖尿病、子痫前期和单脐动脉）后，宫内生长受限的风险仍然相似（调整后的比值比，1.1；95%置信区间，0.9-1.5）。出血的存在并不影响生长受限的风险。
结论
前置胎盘与胎儿生长受限无关。对于前置胎盘的患者，不需要进行连续的生长超声检查。
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